Organization
EXECUTIVE UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT W RICE MC (PRESIDENT)
(419) 627-8771
Entity
Organization
Contact information
Practice address
2800 HAYES AVE, BLDG D, SANDUSKY, OH 44870-7248
(419) 627-8771
(419) 627-0363
Mailing address
2800 HAYES AVENUE, BLDG D, SANDUSKY, OH 44870
(419) 627-8771
(419) 627-0363
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2274793
—
OH
05
—
2281972
—
OH
05
—
2282328
—
OH
01
—
CG9157
RAILROAD MEDICARE
OH
Enumeration date
07/03/2006
Last updated
11/21/2007
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