Riverside Medical Clinic

NPI #1811206923 in Lake City, Arkansas

Provider Information

NPI Number: 1811206923
Entity Type: Organization
Organization Name: Riverside Medical Clinic
Primary Specialty: Family Medicine
Enumeration Date: Oct 7, 2010
Last Updated: Aug 2, 2011

Practice Location

Address: 803 HWY 18
City: Lake City
State: Arkansas
ZIP Code: 72347-0505
Phone: (870) 237-1055

Authorized Official

Name: TOMMY WAGNER
Title: OWNER
Phone: (870) 561-3300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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