# KIDNEY DISEASE AND HYPERTENSION SPECIALISTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447496708
- **Authorized official:** FAYYAZ H SAGARWALA MD (MEMBER)
- **Authorized official phone:** (573) 785-5444

## Contact information

- **Practice address:** 2620 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3396
- **Practice address phone:** (573) 785-7721
- **Mailing address:** 2628 BARRON RD, POPLAR BLUFF, MO 63901-1916
- **Mailing address phone:** (573) 785-5444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 2006018918 | MO | Yes |

## Other

- **Enumeration date:** 12/16/2008
- **Last updated:** 12/16/2008