MEDICARE: 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
1	207RN0300X	Nephrology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811944432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEPHROLOGY ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	129 N BROOKMOORE DR
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-2024
Country	:	US
Telephone Number	:	662-329-3838
Fax Number	:	662-329-2515

Provider Business Practice Location Address
First Line	:	129 N BROOKMOORE DR
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-2024
Country	:	US
Telephone Number	:	662-329-3838
Fax Number	:	662-329-2515

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHRISTOPHER JOSEPH LEBRUN
Credential	:	M.D.
Telephone Number	:	662-329-3838

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	07/02/2012

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