| NPI | 1629857248 |
|---|---|
| Doing Business As | RED RIVER MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JACKIE YVETTE WILSON Office Manager 931-368-9736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2023-10-04 |