Provider Demographics
NPI:1316921091
Name:RICE, DONALD C (OD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:C
Last Name:RICE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 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
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK911152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100762500AMedicaid
OK100762500AMedicaid