Basic Information
Provider Information
NPI: 1780184978
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RICE
FirstName: JEFFREY
MiddleName: KINSLEY
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6600 S YALE AVE
Address2: STE 1400
City: TULSA
State: OK
PostalCode: 741363331
CountryCode: US
TelephoneNumber: 9184886687
FaxNumber: 9184886098
Practice Location
Address1: 6160 S YALE AVE
Address2:  
City: TULSA
State: OK
PostalCode: 741361930
CountryCode: US
TelephoneNumber: 9184973004
FaxNumber: 9184973005
Other Information
ProviderEnumerationDate: 02/14/2018
LastUpdateDate: 07/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X6736OKY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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