Individual
DR. SAILAJA TUMMALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
755 COWAN DRIVE, LEBANON, MO 65536
(417) 532-2805
(417) 532-2865
Mailing address
1622 W CALEB CT, SPRINGFIELD, MO 65810-1525
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2011022971
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206520504
—
MO
05
—
35322100
—
WI
Enumeration date
11/29/2006
Last updated
05/12/2023
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