Provider Demographics
NPI:1497728307
Name:RICE, MELISSA L (OD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:L
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 1:3333 BURNET AVE
Mailing Address - Street 2:ML 4008
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4751
Mailing Address - Fax:513-636-7911
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 4008
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4751
Practice Address - Fax:513-636-7911
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.6250-THER152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN355463500Medicaid
MN410046051Medicare ID - Type UnspecifiedRAILROAD
MN410001676Medicare ID - Type Unspecified
MN355463500Medicaid