Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 0016816 | TN |
NPI | 1023077203 |
---|---|
Provider Name | Dr. Lakshmanan Ganapathy |
First Address | Selmer, TN 38375 |
Second Address | Selmer, TN 38375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 25/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05661 | TLC (01) | TN |
113241 | UNISON (01) | |
3019050 | (05) | TN |
53668 | BCBS TN (01) | |
B58922 | (02) |