Provider Demographics
NPI:1942266408
Name:KRISHNAMURTI, SRIDHAR (PHD)
Entity Type:Individual
Prefix:
First Name:SRIDHAR
Middle Name:
Last Name:KRISHNAMURTI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2257 BARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-4243
Mailing Address - Country:US
Mailing Address - Phone:334-844-9627
Mailing Address - Fax:
Practice Address - Street 1:301 MARIARDEN RD
Practice Address - Street 2:LAKE MARTIN COMMUNITY HOSPITAL
Practice Address - City:DADEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36853
Practice Address - Country:US
Practice Address - Phone:256-825-7821
Practice Address - Fax:256-825-5742
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL788A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist