Provider Demographics
NPI:1528474780
Name:FLOWOOD RIVER OAKS HMA MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:FLOWOOD RIVER OAKS HMA MEDICAL GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AREA MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-936-3121
Mailing Address - Street 1:1080 RIVER OAKS DR
Mailing Address - Street 2:STE. B-104
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9779
Mailing Address - Country:US
Mailing Address - Phone:601-936-3121
Mailing Address - Fax:601-936-3116
Practice Address - Street 1:1040 RIVER OAKS DR
Practice Address - Street 2:STE. 101
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9530
Practice Address - Country:US
Practice Address - Phone:601-933-5405
Practice Address - Fax:601-933-5407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)Group - Multi-Specialty