MEDICARE: DR. CLIFFORD H RICE JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	024389	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093719833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLIFFORD H RICE JR. MD

Provider Business Mailing Address
First Line	:	1455 E BERT KOUNS INDUSTRIAL LOOP
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-5634
Country	:	US
Telephone Number	:	318-798-4500
Fax Number	:	318-798-4601

Provider Business Practice Location Address
First Line	:	1455 E BERT KOUNS INDUSTRIAL LOOP STE 206
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-6000
Country	:	US
Telephone Number	:	318-798-4464
Fax Number	:	318-798-4529

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	02/03/2026

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