# RIVER VALLEY MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1720512601
- **Authorized official:** DR. FREDERICK JOSEPH FUOCO (CONSULTANT)
- **Authorized official phone:** (504) 495-6772

## Contact information

- **Practice address:** 2719 BRYAN RD, VAN BUREN, AR 72956-5031
- **Practice address phone:** (918) 208-4868
- **Mailing address:** 2719 BRYAN RD, VAN BUREN, AR 72956-5031
- **Mailing address phone:** (918) 208-4868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | E-2230 | AR | Yes |

## Other

- **Enumeration date:** 04/17/2017
- **Last updated:** 04/17/2017