Individual
JOSHUA GARDNER TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
PENN STATE M.S. HERSHEY, MED CENTER, DEPT RAD., H066, 500 UNIVERSITY DR, HERSHEY, PA 17033
(717) 531-8521
(717) 531-0922
Mailing address
531 W HIGH ST, HUMMELSTOWN, PA 17036-1906
(717) 220-1379
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MT191695
PA
208D00000X
General Practice Physician
0101235097
VA
Other
Enumeration date
02/16/2006
Last updated
07/27/2007
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