Provider Demographics
NPI:1477886109
Name:ARKANSAS NEPHROLOGY & HYPERTENSION CLINIC PA
Entity Type:Organization
Organization Name:ARKANSAS NEPHROLOGY & HYPERTENSION CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:AHMER
Authorized Official - Last Name:KASHIF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-536-1400
Mailing Address - Street 1:PO BOX 2738
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71613-2738
Mailing Address - Country:US
Mailing Address - Phone:870-536-1400
Mailing Address - Fax:870-536-5196
Practice Address - Street 1:1801 W 40TH AVE
Practice Address - Street 2:SUITE 7A
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-6940
Practice Address - Country:US
Practice Address - Phone:870-536-1400
Practice Address - Fax:870-536-5196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3969174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARH77563Medicare UPIN
AR5G496Medicare PIN