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General NPI Number Information
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NPI Number | 1386587095
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Entity Type | Organization
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Legal Business Name | WEST RIVER HV, PLLC
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Dates
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Enumeration Date | 04/09/2026
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Last Update Date | 04/09/2026
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Provider Practice Location Address
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Address Line | 201 ANAMARIA DR
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City | RAPID CITY
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State | SD
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Zip | 57701-7305
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Country | US
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Telephone | 605-608-0693
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Fax |
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Provider Business Mailing Address
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Address Line | 201 ANAMARIA DR
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City | RAPID CITY
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State | SD
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Zip | 57701-7305
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Country | US
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Telephone | 605-608-0693
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY WILSON
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Credential | MD
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Telephone | 605-608-0693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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