Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 20922 | KY |
NPI | 1003830274 |
---|---|
Provider Name | Dr. Syamala H.k. Reddy |
First Address | Hazard, KY 41701-9466 |
Second Address | Hazard, KY 41701-9466 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 05/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6420924 | (05) | KY |
C74125 | (02) |