Provider Demographics
NPI:1053361337
Name:LAKSHMAN, SANKAR (MD)
Entity type:Individual
Prefix:
First Name:SANKAR
Middle Name:
Last Name:LAKSHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8905 BARTLETT LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-8086
Mailing Address - Country:US
Mailing Address - Phone:865-470-8380
Mailing Address - Fax:
Practice Address - Street 1:850 RIVERVIEW RD
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:KY
Practice Address - Zip Code:40977-1430
Practice Address - Country:US
Practice Address - Phone:276-523-7938
Practice Address - Fax:276-523-7028
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN123862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4009445Medicaid
KY00942001Medicare PIN
TN4009445Medicaid
TN30528312Medicare PIN