COMANCHE NEPHROLOGY PC NPI 1689863946

NPI Information

NPI: 1689863946
Provider Name: COMANCHE NEPHROLOGY PC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
4417 W GORE BLVD
SUITE 1
LAWTON, OK
ZIP 73505
Phone: (580) 536-5273
Get Directions

COMANCHE NEPHROLOGY PC is a nephrology internal medicine in Lawton, OK. 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. COMANCHE NEPHROLOGY PC NPI is 1689863946. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4417 W GORE BLVD
SUITE 1
LAWTON, OK
ZIP 73505-978
Phone: (580) 536-5273

The provider's authorized official is Bali Reddy Sodam .
The authorized official title is Physician and has the following contact phone number (580) 536-5273.

The enumeration date for this NPI number is 10/23/2007 and was last updated on 12/11/2010.

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	24723	OKLAHOMA	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
1	I50032	MEDICARE UPIN	OKLAHOMA
2	500522217	MEDICARE PIN	OKLAHOMA
3	200123460A	MEDICAID	OKLAHOMA

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: 4/28/2024

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