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NPI Code Detail

MEDICARE: INTEGRATED NEPHROLOGY ASSOCIATES, PC

MEDICARE: INTEGRATED NEPHROLOGY ASSOCIATES, PC
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
1207RN0300XNephrology Physician

General Provider Information

NPI Number : 1699905422
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATED NEPHROLOGY ASSOCIATES, PC
Provider Business Mailing Address
First Line : 2411 VILLAGE LN
Second Line :
City : BILLINGS
State : MT
Zip : 59102-2491
Country : US
Telephone Number : 406-248-5511
Fax Number : 406-248-5540
Provider Business Practice Location Address
First Line : 2748 CROSSROADS BLVD
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81506-3933
Country : US
Telephone Number : 970-255-0919
Fax Number : 970-255-0901
Authorized Official
Title or Position : PRESIDENT
Name : DR. GRACE E KIM
Credential : M.D.
Telephone Number : 406-248-5511
Provider Enumeration Date : 07/14/2009
Last Update Date : 07/14/2009

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