# LITTLE RIVER MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326442195
- **Authorized official:** JEFFREY P MADISON (CEO)
- **Authorized official phone:** (512) 446-4500

## Contact information

- **Practice address:** 1717 SW H K DODGEN LOOP, SUITE 103, TEMPLE, TX 76502-1838
- **Practice address phone:** (254) 298-2599
- **Mailing address:** 1713 SW H K DODGEN LOOP, SUITE 122 AND 123, TEMPLE, TX 76502-1836
- **Mailing address phone:** (254) 298-2599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 10/22/2014
- **Last updated:** 10/22/2014