Provider Demographics
NPI:1346394855
Name:KIDNEY AND HYPERTENSION CENTER PC
Entity Type:Organization
Organization Name:KIDNEY AND HYPERTENSION CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-957-1133
Mailing Address - Street 1:2510 NW EDENBOWER BLVD STE 176
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-8899
Mailing Address - Country:US
Mailing Address - Phone:541-957-1133
Mailing Address - Fax:541-957-1799
Practice Address - Street 1:2410 NW EDENBOWER BLVD STE 176
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-8830
Practice Address - Country:US
Practice Address - Phone:541-957-1133
Practice Address - Fax:541-957-1799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23318207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR286437Medicaid
OR286437Medicaid
ORR113534Medicare PIN