Organization
SOUTHWEST KIDNEY INSTITUTE VASCULAR CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY COOPER MD (PRESIDENT)
(602) 277-4429
Entity
Organization
Contact information
Practice address
1100 E UNIVERSITY DR, TEMPE, AZ 85281-8401
(602) 277-4429
Mailing address
2620 N 3RD ST, PHOENIX, AZ 85004-1153
(602) 277-4429
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
02/16/2011
Last updated
07/14/2011
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