Larry D Tice, MD is a
Neurological Surgery physician based in Fruita, Colorado. Larry D Tice is licensed to practice in Colorado (license number 18565) and his current practice location is 551 Kokopelli Blvd, Suite I, Fruita, Colorado. He can be reached at his office (for appointments etc.) via phone at
(970) 858-2580.
NPI number for Larry D Tice is 1942213475 and his current mailing address is 551 Kokopelli Blvd Unit I, Fruita, Colorado. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1942213475.
Physician's Profile
| Full Name | Larry D Tice |
|---|
| Gender | Male |
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| Speciality | Neurological Surgery |
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| Location | 551 Kokopelli Blvd, Fruita, Colorado |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1942213475
- Provider Enumeration Date: 08/14/2006
- Last Update Date: 04/23/2014
Medical Identifiers
Medical identifiers for Larry D Tice such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1942213475 | NPI | - | NPPES |
| 01185651 | Medicaid | CO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207T00000X | Neurological Surgery | 18565 (Colorado) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larry D Tice is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Larry D Tice, MD
551 Kokopelli Blvd Unit I,
Fruita, CO 81521-6305
Ph: (970) 858-2580 | Larry D Tice, MD
551 Kokopelli Blvd, Suite I,
Fruita, CO 81521-6305
Ph: (970) 858-2580 |
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