Individual
VIJAYALAKSHMI PURAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
172 S MAYO TRL, PIKEVILLE, KY 41501-1515
(606) 218-4742
Mailing address
PO BOX 2917, PIKEVILLE, KY 41502-2917
(606) 218-3925
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
27968
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64279680
—
KY
Enumeration date
05/28/2006
Last updated
06/19/2012
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