| NPI | 1558447599 |
|---|---|
| Doing Business As | WHITE RIVER MED PHYSICIANS GROUP/ PAIN MANAGEMENT |
| Entity Type | Organization |
| Authorized Contact | SHAWNA BAXTER Provider Enrollment 870-262-5545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2024-05-02 |