Provider Demographics
NPI:1235322157
Name:KRISHNAN, PALANISWAMY (MD)
Entity Type:Individual
Prefix:DR
First Name:PALANISWAMY
Middle Name:
Last Name:KRISHNAN
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 1:5808 AURORA AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-5255
Mailing Address - Country:US
Mailing Address - Phone:214-257-0972
Mailing Address - Fax:
Practice Address - Street 1:ST. WOOLOS HOSPITAL
Practice Address - Street 2:STOW HILL
Practice Address - City:NEWPORT
Practice Address - State:UK
Practice Address - Zip Code:NP20 4SZ
Practice Address - Country:GB
Practice Address - Phone:00440163-323-4234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPENDING207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine