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Organization

RIVER VALLEY PRIMARY CARE OF POTEAU, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FREDRICK JOSEPH FUOCO MD (OWNER)
(504) 495-6772
Entity
Organization

Contact information

Practice address
502 DEWEY AVE, POTEAU, OK 74953-4216
(504) 495-6772
Mailing address
403 GARRISON AVE APT 202, FORT SMITH, AR 72901-1959

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
N5521
AR
363LF0000X
Family Nurse Practitioner
Primary
128797
AR

Other

Enumeration date
07/17/2018
Last updated
07/17/2018
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