Provider Demographics
NPI:1194875336
Name:CHRONIC KIDNEY DISEASE AND HYPERTENSION SPECIALISTS, LLC
Entity type:Organization
Organization Name:CHRONIC KIDNEY DISEASE AND HYPERTENSION SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARLOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-223-0043
Mailing Address - Street 1:51 S SOUDER AVE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43222-1548
Mailing Address - Country:US
Mailing Address - Phone:614-223-0043
Mailing Address - Fax:614-453-0601
Practice Address - Street 1:51 S SOUDER AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1548
Practice Address - Country:US
Practice Address - Phone:614-223-0043
Practice Address - Fax:614-453-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty