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Organization
NEPHROLOGY ASSOCIATES, PC
Active
Organization
NEPHROLOGY ASSOCIATES, PC
Active
Parent organization
NEPHROLOGY ASSOCIATES, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEPHROLOGY ASSOCIATES, PC
Authorized official
DR. FRANK W BRAXTON M.D. (PRESIDENT/PHYSICIAN)
(573) 334-9564
Entity
Organization
Contact information
Practice address
1409 E MOULTRIE DR, BLYTHEVILLE, AR 72315-6855
(870) 776-1464
(870) 776-1474
Mailing address
1349 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-1727
(573) 334-9564
(573) 334-1879
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117672
BLUE CROSS BLUE SHIELD
MO
01
—
5C446
BLUE CROSS BLUE SHIELD
AR
01
—
CI5170
RAIL ROAD MEDICARE
—
01
—
H8238
HEALTHLINK
—
Enumeration date
11/21/2007
Last updated
11/21/2007
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