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Organization

KENTUCKY NEPHROLOGY RESEARCH TRUST, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID MARSHALL (PRESIDENT)
(270) 684-2110
Entity
Organization

Contact information

Practice address
1101 WINCHESTER RD, SUITE 200, LEXINGTON, KY 40505-4028
(859) 225-4595
Mailing address
115 SAINT ANN ST, OWENSBORO, KY 42303-4145

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
300147
KY
261QM2500X
Medical Specialty Clinic/Center
300147
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39000492
KY
Enumeration date
11/10/2006
Last updated
08/14/2007
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