Northlake Nephrology, Inc

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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