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Organization

NEPHROLOGY AND HYPERTENSION ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAMELA S DODGE MBA (PRACTICE ADMINISTRATOR)
(573) 499-0642
Entity
Organization

Contact information

Practice address
1205 W BROADWAY, COLUMBIA, MO 65203-2125
(573) 499-0642
(573) 449-1787
Mailing address
1205 W BROADWAY, COLUMBIA, MO 65203-2125
(573) 449-4936
(573) 449-6795

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
507480226
MO
01
CH1443
RAILROAD MEDICARE
MO
Enumeration date
06/27/2005
Last updated
10/31/2023
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