Provider Demographics
NPI:1154340453
Name:TRICE, LAURA M (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:M
Last Name:TRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-301-4688
Mailing Address - Fax:859-301-2607
Practice Address - Street 1:1 MEDICAL VILLAGE DRIVE
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:859-301-4688
Practice Address - Fax:859-301-2607
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01086435A207QH0002X
KY35439207QH0002X, 207RH0002X
OH35071032207RG0300X
IN10186435A207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2067141Medicaid
OH2067141Medicaid
OHG655257Medicare ID - Type Unspecified
OH1942301Medicare ID - Type Unspecified