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1124382536
SUDHEER TANGELLA
JACKSON, MS
NPI
1124382536
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MS 836-L)
Enumeration Date
2012-06-29
Last Update Date
2012-06-29
Business Address
-- SUDHEER TANGELLA MD
878 LAKELAND DR
JACKSON, MS 39216-4644
Phone number: 601-984-6800
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Mailing Address
-- SUDHEER TANGELLA MD
PO BOX 4999
JACKSON, MS 39296-4999
Phone number: 601-984-5426
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