Individual
DR. JOSE NELSON RIVERA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2495 SHREVEPORT HWY # 71N, PINEVILLE, LA 71360-4044
(318) 466-2760
Mailing address
PO BOX 69004, ALEXANDRIA, LA 71306-9004
(318) 466-2760
(318) 466-2760
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13337
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13337
MEDICAL LICENSE
PR
Enumeration date
12/26/2005
Last updated
10/22/2015
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