Individual
DR. PRABHAKARAN P GOPALAKRISHNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 SIXTH ST SW STE 710, CANTON, OH 44710-1702
(330) 454-8076
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 921-3431
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L9215
TX
207RC0000X
Cardiovascular Disease Physician
Primary
35.125932
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167626402
—
TX
Enumeration date
06/27/2006
Last updated
10/07/2019
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