Organization · Type 2 NPI

Isd Renal Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Canton, MS

NPI number 1083669089 Active

Practice location

620 E Peace St
Canton, MS 39046

Call (601) 859-3382 Map

Fax (601) 859-8591

Mailing address

5200 Virginia Way, L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

Other end-stage renal disease (esrd) treatment clinic/center providers in Canton

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NPI record

NPI: 1083669089
Entity type: Organization (Type 2)
Issued: May 24, 2006
Last updated: Dec 18, 2025
Status: Active

Other names

<unavail>
Canton Renal Center · doing business as
Canton Renal Center · doing business as

Authorized official

Samuel T Wey
VP Licensure & Certification
(615) 341-6641

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1083669089

Isd Renal Inc's National Provider Identifier is 1083669089, issued on May 24, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Canton, MS. The record was last updated on Dec 18, 2025.