Individual
MANICKAM KRISHNAMURTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
651 DUNLOP LN, CLARKSVILLE, TN 37040-5015
(931) 502-1370
Mailing address
2020 21ST AVE S STE 201, NASHVILLE, TN 37212-4354
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
39352
TN
207P00000X
Emergency Medicine Physician
42882
KY
207R00000X
Internal Medicine Physician
42882
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3328234
—
TN
05
—
3328235
—
TN
01
—
40586
TLC TENNCARE
TN
01
—
4105319
BLUE CROSS
TN
01
—
4151444
BLUE CROSS
TN
01
—
P00254465
MEDICARE RAILROAD
TN
Enumeration date
05/25/2006
Last updated
04/28/2021
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