Provider Demographics
NPI:1053309336
Name:KAIMAL, PARAMESWARA KRISHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:PARAMESWARA
Middle Name:KRISHNA
Last Name:KAIMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:P.
Other - Middle Name:K
Other - Last Name:KAIMAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:211 4TH ST
Mailing Address - Street 2:BOX 30115
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8421
Mailing Address - Country:US
Mailing Address - Phone:318-473-4613
Mailing Address - Fax:318-445-7129
Practice Address - Street 1:501 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 250
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8124
Practice Address - Country:US
Practice Address - Phone:318-473-4613
Practice Address - Fax:318-445-7129
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04645R207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA71301A004OtherTRICARE
LA110004182OtherRAILROAD MEDICARE
LA1196266Medicaid
MS00125771Medicaid
LA1196266Medicaid
MS00125771Medicaid