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General NPI Number Information
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NPI Number | 1346394855
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Entity Type | Organization
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Legal Business Name | KIDNEY AND HYPERTENSION CENTER PC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 2410 NW EDENBOWER BLVD STE 176
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City | ROSEBURG
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State | OR
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Zip | 97471-8830
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Country | US
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Telephone | 541-957-1133
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Fax | 541-957-1799
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Provider Business Mailing Address
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Address Line | 2510 NW EDENBOWER BLVD STE 176
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City | ROSEBURG
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State | OR
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Zip | 97471-8899
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Country | US
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Telephone | 541-957-1133
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Fax | 541-957-1799
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | DR. NEIL KUMAR
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Credential | MD
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Telephone | 541-957-1133
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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 | MD23318
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License Number State | OR
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