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1407078629
MARTIN TICE
MEDFORD, OR
NPI
1407078629
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: OR MD11348)
Enumeration Date
2007-05-03
Last Update Date
2007-07-09
Business Address
Dr. MARTIN TICE MD
1111 CRATER LAKE AVE
MEDFORD, OR 97504-6241
Phone number: 503-215-4323
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Mailing Address
Dr. MARTIN TICE MD
PO BOX 3308
PORTLAND, OR 97208-3308
Phone number: 503-125-4323
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