Healthcare Provider Details

I. General information

NPI: 1922238922
Provider Name (Legal Business Name): NAGA MARUTHI KUMAR PERISETTI MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2009
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 GOODYEAR AVE
GADSDEN AL
35903-1195
US

IV. Provider business mailing address

UNIVERSITY OF KENTUCKY & AFFLIATES 800 ROSE STREET
LEXINGTON KY
40536-0001
US

V. Phone/Fax

Practice location:
  • Phone: 256-494-4000
  • Fax: 659-235-6176
Mailing address:
  • Phone: 859-323-5871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberQ1707
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberQ1707
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberTL34006
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: