| River Valley Primary Care Of Poteau, Llc | |
|
502 Dewey Ave Poteau OK 74953-4216 | |
| (504) 495-6772 | |
| Not Available |
| Full Name | River Valley Primary Care Of Poteau, Llc |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 502 Dewey Ave, Poteau, Oklahoma |
| Authorized Official Name and Position | Fredrick Joseph Fuoco (OWNER) |
| Authorized Official Contact | 5044956772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| River Valley Primary Care Of Poteau, Llc 403 Garrison Ave Apt 202 Fort Smith AR 72901-1959 Ph: () - | River Valley Primary Care Of Poteau, Llc 502 Dewey Ave Poteau OK 74953-4216 Ph: (504) 495-6772 |
| NPI Number | 1043796626 |
|---|---|
| Provider Enumeration Date | 07/17/2018 |
| Last Update Date | 07/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043796626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | N5521 (Arkansas) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 128797 (Arkansas) | Primary |
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