Individual
KRISHNA K LINGALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
42121 US HWY 70, PORTALES, NM 88130-9347
(575) 356-6652
(575) 226-0099
Mailing address
PO BOX 299, PORTALES, NM 88130-9347
(575) 356-6652
(575) 226-0099
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD2004-0760
NM
208100000X
Physical Medicine & Rehabilitation Physician
MD20040760
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25604368
—
NM
Enumeration date
10/03/2006
Last updated
11/27/2012
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