Individual
SRINIVAS ANANTHULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2033 MEADOWVIEW LN, 3RD FLOOR, KINGSPORT, TN 37660-7569
(423) 857-2793
(423) 578-8025
Mailing address
PO BOX 9, KINGSPORT, TN 37660
(423) 857-2066
(423) 857-2070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD39971
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010196701
—
VA
05
—
3333064
—
TN
05
—
3720181
—
TN
Enumeration date
08/01/2005
Last updated
03/20/2014
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