Individual
LAXMAIAH MANCHIKANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2831 LONE OAK RD, PADUCAH, KY 42003-8041
(270) 554-8373
(270) 554-8987
Mailing address
2831 LONE OAK RD, PADUCAH, KY 42003-8041
(270) 554-8373
(270) 554-8987
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
20670
KY
208VP0014X
Interventional Pain Medicine Physician
Primary
20670
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000067584
BCBS
KY
05
—
64206709
—
KY
Enumeration date
10/20/2005
Last updated
09/04/2012
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