Provider Demographics
NPI:1154394914
Name:KRISHNA, JAYA LAKSHMI (MD, FACC)
Entity type:Individual
Prefix:DR
First Name:JAYA
Middle Name:LAKSHMI
Last Name:KRISHNA
Suffix:
Gender:F
Credentials:MD, FACC
Other - Prefix:DR
Other - First Name:BALASUBRAMANIAN
Other - Middle Name:
Other - Last Name:JAYALAKSHMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, FACC
Mailing Address - Street 1:202 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 W BELTLINE HWY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-2316
Practice Address - Country:US
Practice Address - Phone:608-417-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46771-20207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease