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General NPI Number Information
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NPI Number | 1265821193
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Entity Type | Organization
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Legal Business Name | WHITE RIVER HEALTH SYSTEM, INC.
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 1690 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501
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Country | US
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Telephone | 870-793-2371
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Fax | 870-793-7585
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Provider Business Mailing Address
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Address Line | 1690 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501
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Country | US
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Telephone | 870-793-2371
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Fax | 870-793-7585
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT
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Name | SHAWNA BAXTER
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Credential |
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Telephone | 870-262-5545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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