Provider Demographics
NPI:1134288467
Name:LIMESTONE SURGICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:LIMESTONE SURGICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:PRABHAKARA
Authorized Official - Middle Name:BABU
Authorized Official - Last Name:RAVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-232-2275
Mailing Address - Street 1:102 SANDERS STREET
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2814
Mailing Address - Country:US
Mailing Address - Phone:256-232-2275
Mailing Address - Fax:256-232-4401
Practice Address - Street 1:102 SANDERS ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2418
Practice Address - Country:US
Practice Address - Phone:256-232-2275
Practice Address - Fax:256-232-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8230208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty