Organization
S.VISHWANATH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SASIKUMAR VISHWANATH M.D. (PRESIDENT)
(334) 858-2050
Entity
Organization
Contact information
Practice address
1073 3RD ST, FLORALA, AL 36442-3231
(334) 858-2050
(334) 858-2120
Mailing address
1073 3RD ST, FLORALA, AL 36442-3231
(334) 858-2050
(334) 858-2120
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19896
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000037033
—
AL
01
—
110173224
RAILROADMEDICARE
AL
01
—
214372179
TRICARE
AL
05
—
251015400
—
FL
01
—
51037033VIS
HUMANA
AL
01
—
51037033VIS
BLUECROSS OF FLORIDA
FL
01
—
51524095
BLUECROSS OF ALABAMA
AL
Enumeration date
09/21/2006
Last updated
12/05/2011
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