| Jyothi Puram, M.d., Inc | |
|
1176 E Home Rd Springfield OH 45503-2726 | |
| (937) 342-9861 | |
| (380) 203-1298 |
| Full Name | Jyothi Puram, M.d., Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1176 E Home Rd, Springfield, Ohio |
| Authorized Official Name and Position | Madhukar Narahari (OWNER) |
| Authorized Official Contact | 6149433839 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jyothi Puram, M.d., Inc 1604 Lancaster Ave # B Reynoldsburg OH 43068-2639 Ph: (614) 943-3839 | Jyothi Puram, M.d., Inc 1176 E Home Rd Springfield OH 45503-2726 Ph: (937) 342-9861 |
| NPI Number | 1013000926 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 12/13/2023 |
| Medicare PECOS PAC ID | 4789734245 |
|---|---|
| Medicare Enrollment ID | O20090604000332 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013000926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 64595 (Ohio) | Primary |
| Provider Name | Jyothi Puram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699879189 PECOS PAC ID: 0244380707 Enrollment ID: I20090604000327 |
| Provider Name | Emmanuel D'souza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073811915 PECOS PAC ID: 8921399213 Enrollment ID: I20160616000897 |
| Provider Name | Melissa E Writesel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124571542 PECOS PAC ID: 5193115624 Enrollment ID: I20211124000265 |
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