Organization
MITTUR N RAMPRASAD MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITTUR N RAMPRASAD MD (PRESIDENT)
(931) 455-6720
Entity
Organization
Contact information
Practice address
509 NW ATLANTIC ST, TULLAHOMA, TN 37388-3504
(931) 455-6720
(931) 393-2837
Mailing address
509 NW ATLANTIC ST, TULLAHOMA, TN 37388-3504
(931) 455-6720
(931) 393-2837
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD0000013749
TN
2085R0202X
Diagnostic Radiology Physician
MD0000013749
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016097
BCBST
—
05
—
3189056
—
TN
Enumeration date
09/12/2005
Last updated
09/18/2012
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