Provider Demographics
NPI:1285747766
Name:TRICE, JULIA BROWN (MD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:BROWN
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 1:12350 JEFFERSON AVE
Mailing Address - Street 2:SUITE 190
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-6951
Mailing Address - Country:US
Mailing Address - Phone:757-881-9444
Mailing Address - Fax:757-881-9004
Practice Address - Street 1:12350 JEFFERSON AVE
Practice Address - Street 2:SUITE 190
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-6951
Practice Address - Country:US
Practice Address - Phone:757-881-9444
Practice Address - Fax:757-881-9004
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012306112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA84648OtherSENTARA MENTAL HEALH
VA264876000OtherMAGELLAN
VA010371104Medicaid
VA378339OtherVALUEOPTIONS
VA248818OtherVA BC/BS
VA010371104Medicaid
VA84648OtherSENTARA MENTAL HEALH