Provider Demographics
NPI:1992729859
Name:RICE, KEVIN ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ERIC
Last Name:RICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6238 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-4713
Mailing Address - Country:US
Mailing Address - Phone:901-761-4292
Mailing Address - Fax:901-761-7805
Practice Address - Street 1:6238 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4713
Practice Address - Country:US
Practice Address - Phone:901-761-4292
Practice Address - Fax:901-761-7805
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD025048207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMD025048OtherMEDICAL LICENSE
TNF95679Medicare UPIN
TN3825107Medicare UPIN