Organization
CARRUS LAKESIDE HOSPITAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANBU NACHIMUTHU (CHAIRMAN & CEO)
(903) 870-2745
Entity
Organization
Contact information
Practice address
700 W 7TH AVE STE 6, BRISTOW, OK 74010-2302
(918) 807-5033
(918) 367-4481
Mailing address
1810 W US HIGHWAY 82, SHERMAN, TX 75092-7069
(903) 870-2745
(903) 870-2795
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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