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General NPI Number Information
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NPI Number | 1447563499
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Entity Type | Organization
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Legal Business Name | ANOINTED NEPHROLOGY & HTN PLLC
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Dates
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Enumeration Date | 07/20/2010
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 747 INDUSTRIAL PARK RD NE
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City | BROOKHAVEN
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State | MS
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Zip | 39601-2065
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Country | US
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Telephone | 601-833-4111
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Fax | 601-833-1444
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Provider Business Mailing Address
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Address Line | 747 INDUSTRIAL PARK RD NE
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City | BROOKHAVEN
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State | MS
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Zip | 39601-2065
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Country | US
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Telephone | 601-833-4111
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Fax | 601-833-1444
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | JAMES HALL
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Credential | MD
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Telephone | 601-320-3922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 18365
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License Number State | MS
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