Provider Demographics
NPI:1508096009
Name:RIVER OAKS MANAGEMENT, LLC
Entity Type:Organization
Organization Name:RIVER OAKS MANAGEMENT, LLC
Other - Org Name:RANKIN NEUROSURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL PPM CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOYNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:601-936-3100
Mailing Address - Street 1:2550 FLOWOOD DR
Mailing Address - Street 2:402
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9303
Mailing Address - Country:US
Mailing Address - Phone:601-936-3100
Mailing Address - Fax:601-936-3130
Practice Address - Street 1:348 CROSSGATES BLVD
Practice Address - Street 2:1500
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-2700
Practice Address - Country:US
Practice Address - Phone:601-824-1523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC02454Medicare PIN