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General NPI Number Information
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NPI Number | 1225529142
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Entity Type | Organization
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Legal Business Name | KIDNEY EXPERTS PLLC
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Dates
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Enumeration Date | 05/25/2018
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 1575 PARR AVE # B
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City | DYERSBURG
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State | TN
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Zip | 38024
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Country | US
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Telephone | 731-286-1510
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Fax |
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Provider Business Mailing Address
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Address Line | 1575 PARR AVE # B
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City | DYERSBURG
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State | TN
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Zip | 38024-3151
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Country | US
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Telephone | 731-286-1510
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Fax |
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Authorized Official
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Title or Position | NEPHROLOGIST
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Name | DR. ANNA JIYOUNG LEE-MULAY
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Credential | MD
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Telephone | 201-988-1199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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