Provider Demographics
NPI:1356370274
Name:JEFFREY D RICE OD LLC
Entity type:Organization
Organization Name:JEFFREY D RICE OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-454-6283
Mailing Address - Street 1:1180 MILITARY RD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1345
Mailing Address - Country:US
Mailing Address - Phone:740-454-6283
Mailing Address - Fax:740-454-6289
Practice Address - Street 1:1180 MILITARY RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1345
Practice Address - Country:US
Practice Address - Phone:740-454-6283
Practice Address - Fax:740-454-6289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2436242Medicaid
DB3786OtherRAILROAD
OH5768970001Medicare PIN
OH9340861Medicare PIN