# RIVERTON PHYSICIAN PRACTICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wind River Oncology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619236791
- **Authorized official:** JESS N JUDY (PRESIDENT)
- **Authorized official phone:** (615) 372-8500

## Contact information

- **Practice address:** 2100 W SUNSET DR, RIVERTON, WY 82501-2274
- **Practice address phone:** (307) 857-5286
- **Mailing address:** 1005 COLLEGE VIEW DR, RIVERTON, WY 82501-2289
- **Mailing address phone:** (307) 857-5212
- **Mailing address fax:** (307) 857-5215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2012
- **Last updated:** 05/10/2012