NPI Provider: 1366448458
Contact Name: Simon C. John
Position: owner
Phone: (985) 867-8585
Northlake Nephrology, Inc Information:
Northlake Nephrology, Inc organization have npi 1366448458, taxonomy code is 207RN0300X with license number is 21048 in . This Business address located in PO Box 3370, Covington, LA 70434 Louisiana.
Practice Location
Address: 190 Greenbriar Blvd, Covington, LA 70433
Phone: (985) 867-8585
Business Location
Address: PO Box 3370, Covington, LA 70434
Phone: (985) 867-8585
Fax: (714) 456-5330
Taxonomy
Taxonomy Code: 207RN0300X
License Number: 21048
License Number of State: LA
Primary Taxonomy Switch: Y
Enumeration Date: 6/22/2005
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