Provider Demographics
NPI:1699804062
Name:KEYS FAMILY EYE CARE PLC
Entity type:Organization
Organization Name:KEYS FAMILY EYE CARE PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:9180-207-0700
Mailing Address - Street 1:24295 HIGHWAY 82
Mailing Address - Street 2:BUILDING 2
Mailing Address - City:PARK HILL
Mailing Address - State:OK
Mailing Address - Zip Code:74451-4012
Mailing Address - Country:US
Mailing Address - Phone:918-207-0700
Mailing Address - Fax:918-207-0701
Practice Address - Street 1:24295 HIGHWAY 82
Practice Address - Street 2:BUILDING 2
Practice Address - City:PARK HILL
Practice Address - State:OK
Practice Address - Zip Code:74451-4012
Practice Address - Country:US
Practice Address - Phone:918-207-0700
Practice Address - Fax:918-207-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-03
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKDF6544OtherRAIL ROAD MEDICARE
OK200070810AMedicaid
OK200070810AMedicaid
OKU98173Medicare UPIN
OK5689200001Medicare NSC