Organization
RIVER VALLEY PRIMARY CARE, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK JOSEPH FUOCO (SOLE MEMBER)
(504) 495-6772
Entity
Organization
Contact information
Practice address
107 W BROADWAY ST, SPIRO, OK 74959-2417
(479) 262-6069
Mailing address
403 GARRISON AVE APT 202, FORT SMITH, AR 72901-1959
(504) 495-6772
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
N-5521
AR
363LF0000X
Family Nurse Practitioner
Primary
128797
AR
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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