Provider Demographics
NPI:1205192325
Name:ALPINE KIDNEY & HYPERTENSION INSTITUTE
Entity Type:Organization
Organization Name:ALPINE KIDNEY & HYPERTENSION INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-288-9002
Mailing Address - Street 1:154 MYRTLE AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-4850
Mailing Address - Country:US
Mailing Address - Phone:801-288-9002
Mailing Address - Fax:801-288-8987
Practice Address - Street 1:154 MYRTLE AVE STE 204
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-4850
Practice Address - Country:US
Practice Address - Phone:801-288-9002
Practice Address - Fax:801-288-8987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT173525-1205207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD87719Medicare UPIN