Individual
DR. DIVYA LAKSHMI INDRAKANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
112 STONEBRIDGE BLVD, JACKSON, TN 38305-2038
(731) 664-1994
Mailing address
198 MOSES DR, JACKSON, TN 38305-6938
(513) 652-0502
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD0000069208
TN
Other
Enumeration date
04/11/2019
Last updated
10/11/2023
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