Balavittal Varanasi (NPI# 1366419210, PAC ID# 2567456486) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1366419210 |
| PAC ID by PECOS | 2567456486 |
| Professional Enrollment ID | I20040413001416 |
| Full Name | Balavittal Varanasi |
| Address |
936 Martin Luther King Dr Centralia IL 62801 |
| Phone Number | 6185326439 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1979 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140034 | SSM HEALTH ST MARY'S HOSPITAL -CENTRALIA |
| 141345 | SALEM TOWNSHIP HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 936 Martin Luther King Dr, Centralia, IL 62801 | 6185326439 |
| Street Address |
936 MARTIN LUTHER KING DR |
| City | CENTRALIA |
| State | IL |
| Zip | 62801 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa A West | Psychiatry | Community Resource Center Inc | 904 E Martin Luther King Dr, Centralia, IL 62801 |
| Bernard E Rerri | Orthopedic Surgery | 938 Ml King Dr, Centralia, IL 62801 | |
| Corrinne Kleiboeker | Clinical Social Worker | Community Resource Center Inc | 904 E Martin Luther King Dr, Centralia, IL 62801 |
| Kurt S Williams | Chiropractic | Berger Chiropractic Office LLC | 315 N Elm St, Centralia, IL 62801-2954 |
| Joshua J Berger | Chiropractic | Berger Chiropractic Office LLC | 315 N Elm St, Centralia, IL 62801-2954 |
| Tammy L Pike | Clinical Nurse Specialist | Physician Services Corporation of Southern Illinois Inc | 1054 M L King Dr, Suite 105, Centralia, IL 62801-3000 |
| Ronald D Lyons | Clinical Social Worker | 1065 M L King Dr, Centralia, IL 62801-3001 | |
| Cheryl Rushing | Physical Therapy | Orthopaedic Center of Southern Illinois, Ltd | 1007 Ml King Dr, Suite 3, Centralia, IL 62801-3001 |
| Mark A Murfin Jr. | General Surgery | 1063 Martin Luther King Dr, Centralia, IL 62801-3001 | |
| Susan C Portner | Physical Therapy | Orthopaedic Center of Southern Illinois, Ltd | 1007 Ml King Dr, Suite 3, Centralia, IL 62801-3001 |
| Find all physicians in zip 62801 | |||
| City | CENTRALIA |
| Zip Code | 62801 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | CENTRALIA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Balavittal Varanasi.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.