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General NPI Number Information
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NPI Number | 1700227568
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Entity Type | Organization
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Legal Business Name | RICE DERMATOLOGY, PLLC
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Dates
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Enumeration Date | 07/09/2013
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 3915 E 51ST ST
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City | TULSA
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State | OK
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Zip | 74135-3605
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Country | US
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Telephone | 918-749-5714
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Fax |
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Provider Business Mailing Address
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Address Line | 3915 E 51ST ST
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City | TULSA
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State | OK
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Zip | 74135-3605
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTEN RICE
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Credential | MD
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Telephone | 405-206-4043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 29598
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License Number State | OK
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