Organization
DOUGLASVILLE NEPHROLOGY & HTN CLINIC
Active
Other names
Douglasville Nephrology
Organization subpart
No
Provider details
NPI number
Authorized official
DOREEN SMALLS (OFFICE MANAGER)
(770) 489-4978
Entity
Organization
Contact information
Practice address
6488 SPRING ST STE 100, DOUGLASVILLE, GA 30134-1895
(770) 489-4978
(770) 489-5279
Mailing address
6488 SPRING ST STE 100, DOUGLASVILLE, GA 30134-1895
(770) 489-4978
(770) 489-5279
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
40859
GA
207RN0300X
Nephrology Physician
Primary
40859
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006937877P
—
GA
05
—
00693877L
—
GA
05
—
00693877M
—
GA
05
—
00693877P
—
GA
05
—
00693877R
—
GA
05
—
00693877V
—
GA
05
—
00693877Z
—
GA
01
—
10038018
AMERIGROUP
GA
01
—
12085
COVENTRY
GA
01
—
303395
WELLCARE
GA
01
—
6443
KAISER PERMANENTE
GA
Enumeration date
01/05/2007
Last updated
02/14/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up