SOUTHEAST REGIONAL KIDNEY AND HYPERTENSION SPECIALISTS, LL – NPI #1104174655
Internal Medicine

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

SOUTHEAST REGIONAL KIDNEY AND HYPERTENSION SPECIALISTS, LL is a provider located in VIDALIA, GA. NPPES has assigned the NPI number 1104174655 to SOUTHEAST REGIONAL KIDNEY AND HYPERTENSION SPECIALISTS, LL on August 15, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207RN0300X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Nephrology

The NPI profile was previously updated about 12 years ago on Aug 25, 2014. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTHEAST REGIONAL KIDNEY AND HYPERTENSION SPECIALISTS, LL below.

NPI Profile for
SOUTHEAST REGIONAL KIDNEY AND HYPERTENSION SPECIALISTS, LL

NPI Number
1104174655
Enumeration Date

(about 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTHEAST REGIONAL KIDNEY AND HYPERTENSION SPECIALISTS, LL
Primary location
1811 MANNING DR
VIDALIA, GA 30474-8921
Phone: (912) 535-2554 Fax: (912) 535-2558
Mailing address
PO BOX 407
VIDALIA, GA 30475-0407
Phone: (912) 537-4986 Fax: (912) 535-2558
Organization Subpart
Yes - SOUTHEAST REGIONAL KIDNEY AND HYPERTENSION SPECIALISTS, LL is subpart of another organization.
Authorized Official
TONY OSTEEN
CFO
Phone: (912) 538-5314
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RN0300X
- Internal Medicine / Nephrology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.