| Doctor Name: | JOSHUA GARDNER TICE |
| NPI Number: | 1710951579 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 0101235097 |
| Business Practice Address: | Penn State M.s. Hershey, Med Center, Dept Rad., H066 500 University Dr Hershey, PA - 17033 |
| Business Phone Number: | 7175318521 |
| Business Fax Number: | 7175310922 |
| Mailing Address: | 531 W High St, HUMMELSTOWN |
| State: | PA |
| Postal Code: | 170361906 |
| Phone Number: | 7172201379 |
| Fax Number: | |
| NPI Enumeration Date: | 02/16/2006 |
| NPI Last Update Date: | 07/27/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101235097 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |