Organization
SURESH KRISHNAMOORTHY MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURESH KRISHNAMOORTHY MD (PHYSICIAN)
(618) 533-5500
Entity
Organization
Contact information
Practice address
1054 M L KING DR, SUITE 126, CENTRALIA, IL 62801-3000
(618) 533-5500
(618) 533-5501
Mailing address
1054 M L KING DR, SUITE 126, CENTRALIA, IL 62801-3000
(618) 533-5500
(618) 533-5501
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
IL
Other
Enumeration date
06/12/2007
Last updated
08/22/2020
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