Organization
FORKED DEER RIVER INPATIENT SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY KONDAS (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
400 E TICKLE ST, DYERSBURG, TN 38024-3120
(731) 285-2410
(800) 305-3233
Mailing address
815 S PALAFOX ST, 3RD FLOOR, PENSACOLA, FL 32502-5960
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/17/2013
Last updated
12/21/2020
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