Provider Demographics
NPI:1568642544
Name:NEPHROLOGY & HYPERTENSION CLINIC, P.C.
Entity Type:Organization
Organization Name:NEPHROLOGY & HYPERTENSION CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBOGU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-669-9669
Mailing Address - Street 1:1136 CLEVELAND AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-3618
Mailing Address - Country:US
Mailing Address - Phone:404-669-9669
Mailing Address - Fax:404-669-9668
Practice Address - Street 1:1136 CLEVELAND AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-3618
Practice Address - Country:US
Practice Address - Phone:404-669-9669
Practice Address - Fax:404-669-9668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty