Provider Demographics
NPI:1477879054
Name:DR DONALD C RICE OPTOMETRIST INC
Entity Type:Organization
Organization Name:DR DONALD C RICE OPTOMETRIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:580-255-0988
Mailing Address - Street 1:1320 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-4329
Mailing Address - Country:US
Mailing Address - Phone:580-255-0988
Mailing Address - Fax:580-252-7751
Practice Address - Street 1:1320 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-4329
Practice Address - Country:US
Practice Address - Phone:580-255-0988
Practice Address - Fax:580-252-7751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100762500AMedicaid
OKT40619Medicare UPIN
OK100762500AMedicaid