MEDICARE: RIVER OAKS MANAGEMENT COMPANY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1881862449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER OAKS MANAGEMENT COMPANY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 689022
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37068-9022
Country	:	US
Telephone Number	:	615-465-7000
Fax Number	:	615-628-6877

Provider Business Practice Location Address
First Line	:	5345 HIGHWAY 18 W
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39209-9421
Country	:	US
Telephone Number	:	601-922-6113
Fax Number	:	901-922-2281

Authorized Official
Title or Position	:	SR. DIRECTOR
Name	:	MR. JAMES P WRIGHT
Credential	:
Telephone Number	:	615-465-7587

Provider Enumeration Date	:	02/18/2008
Last Update Date	:	02/11/2015

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