Provider Demographics
NPI:1114794286
Name:NEPHROLOGY AND HYPERTENSION ASSOCIATES
Entity Type:Organization
Organization Name:NEPHROLOGY AND HYPERTENSION ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DODGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-499-0642
Mailing Address - Street 1:1205 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2125
Mailing Address - Country:US
Mailing Address - Phone:573-499-0642
Mailing Address - Fax:573-449-1787
Practice Address - Street 1:1205 W BROADWAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2125
Practice Address - Country:US
Practice Address - Phone:573-499-0642
Practice Address - Fax:573-449-1787
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEPHROLOGY AND HYPERTENSION ASSOCIATES, LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty