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General NPI Number Information
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NPI Number | 1710993548
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Entity Type | Organization
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Legal Business Name | NANDALAL YEPURI MD CLARKSVILLE LLC
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 701 EASTERN BLVD
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City | CLARKSVILLE
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State | IN
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Zip | 47129-2338
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Country | US
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Telephone | 812-284-4437
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Fax | 812-285-0256
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Provider Business Mailing Address
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Address Line | 701 EASTERN BLVD
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City | CLARKSVILLE
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State | IN
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Zip | 47129-2338
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Country | US
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Telephone | 812-284-4437
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Fax | 812-285-0256
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Authorized Official
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Title or Position | MD OWNER
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Name | NANDALAL YEPURI
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Credential | MD
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Telephone | 812-284-4437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01027999
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License Number State | IN
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