Provider Demographics
NPI:1922196914
Name:NORTHERN ARIZONA KIDNEY CARE AND HYPERTENSION CENTER, PC
Entity Type:Organization
Organization Name:NORTHERN ARIZONA KIDNEY CARE AND HYPERTENSION CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF THE CO
Authorized Official - Prefix:MR
Authorized Official - First Name:HARNATH
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-213-1443
Mailing Address - Street 1:823 N BEAVER ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001
Mailing Address - Country:US
Mailing Address - Phone:928-213-1443
Mailing Address - Fax:928-213-1442
Practice Address - Street 1:823 N BEAVER ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001
Practice Address - Country:US
Practice Address - Phone:928-213-1443
Practice Address - Fax:928-213-1442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ405953Medicaid
AZ405953Medicaid
G63926Medicare UPIN