Basic Information
| Provider Information | |||||||||
| NPI: | 1306858741 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAYAVEERAPANDIAN | ||||||||
| FirstName: | BHAMA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1002 S LINCOLN ST | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 501383121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6418422151 | ||||||||
| FaxNumber: | 6418421470 | ||||||||
| Practice Location | |||||||||
| Address1: | 1202 W HOWARD ST | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 501383103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6418287211 | ||||||||
| FaxNumber: | 6418427030 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2006 | ||||||||
| LastUpdateDate: | 11/14/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 630031H | IA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.