Organization
KIDNEY DIALYSIS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZMI KABBANI M.D. (ORGANIZER)
(478) 745-5455
Entity
Organization
Contact information
Practice address
640 MARTIN LUTHER KING JR BLVD, SUITE 100, MACON, GA 31201-3206
(478) 742-5850
(478) 742-5860
Mailing address
640 MARTIN LUTHER KING JR BLVD, SUITE 100, MACON, GA 31201-3206
(478) 742-5850
(478) 742-5860
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
GA
Other
Enumeration date
06/03/2008
Last updated
10/15/2008
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