Organization
SOUTHWESTERN NEPHROLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBRAMONIAN JAYKUMAR MD (OWNER)
(724) 228-1303
Entity
Organization
Contact information
Practice address
764 LOCUST AVE, WASHINGTON, PA 15301-2756
(724) 228-1303
(724) 228-1513
Mailing address
764 LOCUST AVE, WASHINGTON, PA 15301-2756
(724) 228-1303
(724) 228-1513
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD035880L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009503000
—
WV
05
—
0181888
—
OH
Enumeration date
06/30/2006
Last updated
08/22/2020
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