Organization
PRASANNA SRINAGESH MD PC
Active
Organization
PRASANNA SRINAGESH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BELL (OFFICE MANAGER)
(912) 285-2053
Entity
Organization
Contact information
Practice address
220 UVALDA ST, WAYCROSS, GA 31501-4569
(912) 285-2053
Mailing address
220 UVALDA ST, WAYCROSS, GA 31501-4569
(912) 285-2053
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0031128511E
—
GA
01
—
1154835965
UHC
GA
Enumeration date
11/14/2022
Last updated
11/14/2022
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