Individual
GREGORY KEITH TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
118 OBRANNAN PARK DR, DOTHAN, AL 36303-2052
(334) 305-2800
(866) 554-1248
Mailing address
118 OBRANNAN PARK DR, DOTHAN, AL 36303-2052
(334) 305-2800
(866) 554-1248
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-074520
AL
Other
Enumeration date
03/12/2019
Last updated
03/29/2026
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