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Contact Information

KRISHNAMOHAN R BASARAKODU, MD
1108 ROSS CLARK CIR
DOTHAN, AL36301-3022
 Phone: 334-944-4673
 Fax: 334-712-3309
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KRISHNAMOHAN R BASARAKODU · (Male)

NPI Number 1235248477
Status Active
Credentials MD
Entity Individual
Enumeration date 08/30/2006
Last updated 04/25/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MO License # 2007001544
Hospital affiliation(s)
  • MEDICAL CENTER ENTERPRISE - (Acute Care)
    400 N EDWARDS STREET
    ENTERPRISE, AL 36330
  • SOUTHEAST ALABAMA MEDICAL CENTER - (Acute Care)
    1108 ROSS CLARK CIRCLE
    DOTHAN, AL 36301
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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