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General NPI Number Information
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NPI Number | 1447310420
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Entity Type | Organization
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Legal Business Name | RIVER CITY GERIATRICS
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 6823 HIGHWAY 311
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City | SELLERSBURG
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State | IN
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Zip | 47172-1801
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Country | US
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Telephone | 502-541-3494
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Fax | 502-526-4565
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Provider Business Mailing Address
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Address Line | 6823 HIGHWAY 311
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City | SELLERSBURG
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State | IN
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Zip | 47172-1801
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Country | US
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Telephone | 502-541-3494
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Fax | 502-526-4565
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | MR. JAYESH SHETH
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Credential | MD
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Telephone | 502-541-3494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 36086
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License Number State | KY
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