MEDICARE: ANOINTED NEPHROLOGY & HTN PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	18365	MS

General Provider Information

NPI Number	:	1447563499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANOINTED NEPHROLOGY & HTN PLLC

Provider Business Mailing Address
First Line	:	747 INDUSTRIAL PARK RD NE
Second Line	:
City	:	BROOKHAVEN
State	:	MS
Zip	:	39601-2065
Country	:	US
Telephone Number	:	601-833-4111
Fax Number	:	601-833-1444

Provider Business Practice Location Address
First Line	:	747 INDUSTRIAL PARK RD NE
Second Line	:
City	:	BROOKHAVEN
State	:	MS
Zip	:	39601-2065
Country	:	US
Telephone Number	:	601-833-4111
Fax Number	:	601-833-1444

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	JAMES HALL
Credential	:	MD
Telephone Number	:	601-320-3922

Provider Enumeration Date	:	07/20/2010
Last Update Date	:	10/05/2016

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