Individual
DR. JYOTHI PURAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1730 E HIGH ST, SPRINGFIELD, OH 45505-1208
(937) 325-5583
(937) 325-8113
Mailing address
1730 E HIGH ST, SPRINGFIELD, OH 45505-1208
(937) 325-5583
(937) 325-8113
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
64595
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0941753
—
OH
Enumeration date
09/12/2006
Last updated
09/23/2011
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