Provider Demographics
NPI:1255328035
Name:DRESDEN MEDICAL ASSOCIATES, P. C.
Entity type:Organization
Organization Name:DRESDEN MEDICAL ASSOCIATES, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KUMAR
Authorized Official - Middle Name:P
Authorized Official - Last Name:YOGESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-364-3196
Mailing Address - Street 1:130 E LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:DRESDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38225-1467
Mailing Address - Country:US
Mailing Address - Phone:731-364-3196
Mailing Address - Fax:731-364-5359
Practice Address - Street 1:130 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:DRESDEN
Practice Address - State:TN
Practice Address - Zip Code:38225-1467
Practice Address - Country:US
Practice Address - Phone:731-364-3196
Practice Address - Fax:731-364-5359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21214207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3703966Medicaid
TN3703966Medicaid