Organization
KSP HEALTH - TN LLC
Active
Parent organization
KSP HEALTH - TN LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KSP HEALTH - TN LLC
Authorized official
MR. MUTHUKUMAR VELLAICHAMY MD (SOLE MEMBER)
(316) 516-2853
Entity
Organization
Contact information
Practice address
116 AGNES RD STE 200, KNOXVILLE, TN 37919-6306
(316) 516-2853
Mailing address
6446 E CENTRAL AVE STE 183, WICHITA, KS 67206-1923
(316) 516-2853
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/03/2024
Last updated
07/03/2024
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