| Doctor Name: | DR. SURENDRA K PUROHIT |
| NPI Number: | 1265506703 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 04588R |
| Business Practice Address: | 71207 Highway 21 Covington, LA - 704337121 |
| Business Phone Number: | 9858926811 |
| Business Fax Number: | 9858928767 |
| Mailing Address: | 71207 Highway 21, COVINGTON |
| State: | LA |
| Postal Code: | 704337121 |
| Phone Number: | 9858926811 |
| Fax Number: | 9858928767 |
| NPI Enumeration Date: | 11/17/2006 |
| NPI Last Update Date: | 08/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 04588R |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |