Individual
RAJASEKHAR TANIKELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 HOSPITAL DR, LEBANON, MO 65536-9238
(417) 533-6100
Mailing address
120 HOSPITAL DR, LEBANON, MO 65536-9238
(417) 533-6100
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
2014027806
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
08/29/2012
Last updated
07/21/2022
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