| NPI | 1205723459 |
|---|---|
| Doing Business As | WHITE RIVER HEALTH ENT |
| Entity Type | Organization |
| Authorized Contact | SHAWNA BAXTER Provider Enrollment Specialist 870-262-5545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 231H00000X Audiologist |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-06-20 |
| Last Update Date | 2025-06-20 |