MEDICARE: STEPHEN D RICE M.D.

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	174400000X	Specialist	12453R	LA
2	2085R0202X	Diagnostic Radiology Physician	12453R	LA
3	2085R0204X	Vascular & Interventional Radiology Physician	12453R	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	300083625	OTHER	LA	RAILROAD MEDICARE

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	:	1144228495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN D RICE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 6284
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71307-6284
Country	:	US
Telephone Number	:	318-442-8399
Fax Number	:	318-448-9897

Provider Business Practice Location Address
First Line	:	3704 NORTH BLVD
Second Line	:	SUITE 1
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-3658
Country	:	US
Telephone Number	:	318-442-8399
Fax Number	:	318-448-9897

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	05/09/2011

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Directions to “ STEPHEN D RICE M.D.” Practice Location

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