Individual
DR. NATHAN DANIEL STICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 781-5111
(270) 780-0466
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 781-5111
(270) 780-0466
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
43657
KY
207V00000X
Obstetrics & Gynecology Physician
TP243
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000670633
ANTHEM
KY
05
—
7100124340
—
KY
Enumeration date
02/18/2007
Last updated
11/14/2014
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