Organization
YN PAKKALA M.D, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NITHYANANDA PAKKALA MD (DOCTOR)
(731) 658-6011
Entity
Organization
Contact information
Practice address
630 NUCKOLLS RD, BOLIVAR, TN 38008-1532
(731) 658-6011
(731) 658-9884
Mailing address
630 NUCKOLLS RD, BOLIVAR, TN 38008-1532
(731) 658-6011
(731) 658-9884
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD9916
TN
Other
Enumeration date
07/12/2012
Last updated
09/09/2013
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