Mid-South Renal Clinic, Plc

NPI #1093724346 in Marion, Arkansas

Provider Information

NPI Number: 1093724346
Entity Type: Organization
Organization Name: Mid-South Renal Clinic, Plc
Primary Specialty: Specialist
Enumeration Date: Aug 5, 2006
Last Updated: May 3, 2013

Practice Location

Address: 1120 STATE HIGHWAY 77 STE 1
City: Marion
State: Arkansas
ZIP Code: 72364-9046
Phone: (870) 733-1177

Authorized Official

Name: MASHHUD M. MIRZA, M.D.
Title: PRESIDENT
Phone: (870) 733-1177

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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