Organization
LAKSHMIKANTHA KUMBLA MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA L TURNER (PHYSICIAN PRACTICE ANALYST)
(615) 321-5577
Entity
Organization
Contact information
Practice address
29 L V STABLER DR, GREENVILLE, AL 36037-3850
(334) 383-2249
(334) 383-2342
Mailing address
PO BOX 563, 29 LV STABLER DR, GREENVILLE, AL 36037-0563
(334) 383-2249
(334) 383-2249
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009943095
—
AL
01
—
051501011
BCBS OP
AL
01
—
051550228
BCBS IP
AL
05
—
051550228
—
AL
Enumeration date
05/15/2007
Last updated
08/13/2008
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