| NPI | 1881489789 |
|---|---|
| Doing Business As | WHITE RIVER HEALTH UROLOGY |
| Entity Type | Organization |
| Authorized Contact | SHAWNA BAXTER Provider Enrollment Specialist 870-262-5545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2025-07-09 |