Organization
NEPHROLOGY ASSOCIATES, PC
Active
Parent organization
NEPHROLOGY ASSOCIATES, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEPHROLOGY ASSOCIATES, PC
Authorized official
DR. FRANK W BRAXTON M.D. (PRESIDENT/PHYSICIAN)
(573) 334-9564
Entity
Organization
Contact information
Practice address
1409 E MOULTRIE DR, BLYTHEVILLE, AR 72315-6855
(870) 776-1464
(870) 776-1474
Mailing address
1349 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-1727
(573) 334-9564
(573) 334-1879
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117672
BLUE CROSS BLUE SHIELD
MO
01
—
5C446
BLUE CROSS BLUE SHIELD
AR
01
—
CI5170
RAIL ROAD MEDICARE
—
01
—
H8238
HEALTHLINK
—
Enumeration date
11/21/2007
Last updated
11/21/2007
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