Organization
KIDNEY DISEASE CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEEPAK MITTAL M.D. (PHYSICIAN)
(859) 534-0861
Entity
Organization
Contact information
Practice address
47 CAVALIER BLVD, SUITE 120, FLORENCE, KY 41042-3969
(859) 534-0861
(859) 534-0865
Mailing address
47 CAVALIER BLVD, SUITE 120, FLORENCE, KY 41042-3969
(859) 534-0861
(859) 534-0865
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2843249
—
OH
05
—
7100040200
—
KY
Enumeration date
06/14/2007
Last updated
04/11/2013
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