Provider Demographics
NPI:1851497648
Name:JOGLEKAR, SHIRISH (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIRISH
Middle Name:
Last Name:JOGLEKAR
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 1:221 STERLING FARM DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-5727
Mailing Address - Country:US
Mailing Address - Phone:731-668-1199
Mailing Address - Fax:731-668-9256
Practice Address - Street 1:221 STERLING FARM DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-5727
Practice Address - Country:US
Practice Address - Phone:731-668-1199
Practice Address - Fax:731-668-9256
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD021233207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3062117Medicaid
A62849Medicare UPIN
TN3062117Medicaid