MEDICARE: KEYS FAMILY EYE CARE PLC

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	152W00000X	Optometrist	2400	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DF6544	OTHER	OK	RAIL ROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1699804062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEYS FAMILY EYE CARE PLC

Provider Business Mailing Address
First Line	:	24295 HIGHWAY 82
Second Line	:	BUILDING 2
City	:	PARK HILL
State	:	OK
Zip	:	74451-4012
Country	:	US
Telephone Number	:	918-207-0700
Fax Number	:	918-207-0701

Provider Business Practice Location Address
First Line	:	24295 HIGHWAY 82
Second Line	:	BUILDING 2
City	:	PARK HILL
State	:	OK
Zip	:	74451-4012
Country	:	US
Telephone Number	:	918-207-0700
Fax Number	:	918-207-0701

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. STEPHANIE MICHELLE RICE
Credential	:	O.D.
Telephone Number	:	91802070700

Provider Enumeration Date	:	03/03/2007
Last Update Date	:	08/26/2010

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Directions to “KEYS FAMILY EYE CARE PLC ” Practice Location

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