Healthcare Provider Details

I. General information

NPI: 1740411230
Provider Name (Legal Business Name): RIVER OAKS MANAGEMENT COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2009
Last Update Date: 07/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 S PEAR ORCHARD RD SUITE 15
RIDGELAND MS
39157-4800
US

IV. Provider business mailing address

2550 FLOWOOD DR SUITE 402
FLOWOOD MS
39232-9303
US

V. Phone/Fax

Practice location:
  • Phone: 601-378-1774
  • Fax: 601-978-1778
Mailing address:
  • Phone: 601-936-3100
  • Fax: 601-936-3130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LATOYA SATCHER
Title or Position: DIRECTOR, PROVIDER CREDENTIALING
Credential:
Phone: 601-936-3121