Organization
KIDNEY DISEASE & HYPERTENSION CENTERS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL R BRUNT MD (PRESIDENT)
(228) 762-0713
Entity
Organization
Contact information
Practice address
2712 CRISWELL AVE, PASCAGOULA, MS 39567-1143
(228) 762-0713
(228) 762-0712
Mailing address
2712 CRISWELL AVE, PASCAGOULA, MS 39567-1143
(228) 762-0713
(228) 762-0712
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
09811
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014436
—
MS
Enumeration date
07/01/2006
Last updated
08/22/2020
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