Provider Demographics
NPI:1033185541
Name:RICE, KARLA LOUISE (OD)
Entity Type:Individual
Prefix:DR
First Name:KARLA
Middle Name:LOUISE
Last Name:RICE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 CHANDLER RD
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-4627
Mailing Address - Country:US
Mailing Address - Phone:918-682-2181
Mailing Address - Fax:918-686-7988
Practice Address - Street 1:2300 CHANDLER RD
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-4627
Practice Address - Country:US
Practice Address - Phone:918-682-2181
Practice Address - Fax:918-686-7988
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2315152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100764520BMedicaid
OKP00769775OtherRAIL ROAD MEDICARE
OK6461750001Medicare PIN