Provider Demographics
NPI:1073707543
Name:RENAL SPECIALTY PHYSICIANS, LLC
Entity Type:Organization
Organization Name:RENAL SPECIALTY PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-845-9000
Mailing Address - Street 1:397 HIGHWAY 21
Mailing Address - Street 2:STE 601
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-3407
Mailing Address - Country:US
Mailing Address - Phone:985-845-9000
Mailing Address - Fax:985-845-9003
Practice Address - Street 1:397 HIGHWAY 21
Practice Address - Street 2:STE 601
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447-3407
Practice Address - Country:US
Practice Address - Phone:985-845-9000
Practice Address - Fax:985-845-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty