Provider Demographics
NPI:1417021353
Name:RICE, JOHN F (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:RICE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CHECOTAH
Mailing Address - State:OK
Mailing Address - Zip Code:74426-3602
Mailing Address - Country:US
Mailing Address - Phone:918-473-2278
Mailing Address - Fax:918-473-5999
Practice Address - Street 1:116 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:CHECOTAH
Practice Address - State:OK
Practice Address - Zip Code:74426-3602
Practice Address - Country:US
Practice Address - Phone:918-473-2278
Practice Address - Fax:918-473-5999
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100057810AMedicaid
OKE09778Medicare UPIN