Jwm Renal, LLC
Internal Medicine, Nephrology in Covington, LA. Organization (NPI-2).
NPI number1790665396
StatusActive
Last updated in NPPESOct 21, 2025
Details
- NPI
- 1790665396
- Entity type
- Organization (NPI-2)
- Legal business name
- Jwm Renal, LLC
- Organization subpart
- No
- Enumeration date
- Sep 4, 2025
- Certification date
- Oct 21, 2025
- Last updated
- Oct 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RN0300X | Internal Medicine, Nephrology | – | – | Yes |
Practice location
1970 N Highway 190Covington, LA 70433-5364
Phone 985-867-8585 · Fax 985-867-3644
Mailing address
Po Box 3370Covington, LA 70434-3370
Phone 985-867-8585 · Fax 985-867-3644
Other practice locations
1415 Avenue F
Bogalusa, LA 70427-4340
Bogalusa, LA 70427-4340
Phone 985-867-8585 · Fax 985-867-3644
Authorized official
Jon W Mares
Provider / Owner
9852565599
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