Individual
KUPPUSWAMY JAGARLAMUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-9253
(217) 258-2250
(217) 258-2249
Mailing address
1000 HEALTH CENTER DR, MATTOON, IL 61938-9253
(217) 258-2250
(217) 258-2249
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
247809
NY
207RH0003X
Hematology & Oncology Physician
Primary
036-128607
IL
Other
Enumeration date
03/04/2008
Last updated
07/26/2011
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