Individual
DR. PURUSHOTHAMAN MADHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1265 E COLLEGE ST, PULASKI, TN 38478-4541
(931) 363-7531
Mailing address
7319 GENTLE WILLOW LN, KATY, TX 77494-0145
(346) 515-7282
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
N0935
TX
208000000X
Pediatrics Physician
051976
GA
208000000X
Pediatrics Physician
295558
NY
208000000X
Pediatrics Physician
Primary
69971
TN
208000000X
Pediatrics Physician
FTL42125
TX
208000000X
Pediatrics Physician
N0935
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
916968941C
—
GA
Enumeration date
08/31/2006
Last updated
02/12/2025
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