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EAGLES LANDING NEPHROLOGY AND HYPERTENSION LLC NPI 1205294378


NPI Information

NPI: 1205294378
Provider Name: EAGLES LANDING NEPHROLOGY AND HYPERTENSION LLC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
225 COUNTRY CLUB DR STE 140
STOCKBRIDGE, GA
ZIP 30281
Phone: (770) 415-5889
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EAGLES LANDING NEPHROLOGY AND HYPERTENSION LLC is a nephrology internal medicine in Stockbridge, GA. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. EAGLES LANDING NEPHROLOGY AND HYPERTENSION LLC NPI is 1205294378. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

225 COUNTRY CLUB DR STE 140
STOCKBRIDGE, GA
ZIP 30281-392
Phone: (770) 415-5889
Fax: (770) 415-5890

The provider's authorized official is Chudamani Rao Polkampally .
The authorized official title is Owner and has the following contact phone number (770) 415-5889.

The enumeration date for this NPI number is 2/4/2016 and was last updated on 4/30/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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