Provider Demographics
NPI:1023030152
Name:NEPHROLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:NEPHROLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT FINANCIAL SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-226-5900
Mailing Address - Street 1:35 W LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7253
Mailing Address - Country:US
Mailing Address - Phone:205-226-5900
Mailing Address - Fax:205-226-5937
Practice Address - Street 1:35 W LAKESHORE DR STE 200
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-7250
Practice Address - Country:US
Practice Address - Phone:205-226-5900
Practice Address - Fax:205-226-5937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6288207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALNE528901220Medicaid
AL1023030152OtherGROUP NPI
AL1023030152OtherGROUP NPI
ALNE528901220Medicaid