Individual
DR. ASHISH TULSIDAS AGRAWAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 541-5000
Mailing address
257 BANCORP SOUTH PKWY, JACKSON, TN 38305-7582
(888) 664-8297
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A67061
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A67061
CA
207RP1001X
Pulmonary Disease Physician
Primary
A67061
CA
208M00000X
Hospitalist Physician
A67061
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-535-022-8
ECFMG
—
05
—
00A670610
—
CA
01
—
P00142722
MEDICARE RR
CA
Enumeration date
09/20/2006
Last updated
07/02/2026
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