SOUTHSIDE KIDNEY CLINICS PC NPI 1659398600

NPI Information

NPI: 1659398600
Provider Name: SOUTHSIDE KIDNEY CLINICS, PC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 11D0933005

Address:
3580 CAMERON PARKWAY
STOCKBRIDGE, GA
ZIP 30281
Phone: (770) 996-6446
Get Directions

SOUTHSIDE KIDNEY CLINICS, PC 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. SOUTHSIDE KIDNEY CLINICS, PC NPI is 1659398600. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3580 CAMERON PARKWAY
STOCKBRIDGE, GA
ZIP 30281
Phone: (770) 996-6446
Fax: (770) 996-6279

The provider's authorized official is Kim A Thorpe .
The authorized official title is Lpn Office Manager and has the following contact phone number (770) 996-6446.

The CLIA number assigned to this NPI record is 11D0933005 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/16/2006 and was last updated on 1/14/2008.

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
1	207RN0300X	Internal Medicine	Nephrology		GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GRP3713	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA

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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