Organization
RIVER PARK PHYSICIAN GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL S. SLIPKOVICH (CEO)
(615) 764-3000
Entity
Organization
Contact information
Practice address
1589 SPARTA STREET, MC MINNVILLE, TN 37110-1392
(931) 815-4101
(931) 815-4640
Mailing address
1559 SPARTA STREET, MCMINNVILLE, TN 37110-1392
(931) 815-4101
(931) 815-4640
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1512651
—
TN
Enumeration date
01/20/2009
Last updated
03/27/2012
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