Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | R 3235 | AR |
NPI | 1073514584 |
---|---|
Provider Name | Prabhakara K Reddy |
First Address | Hot Springs, AR 71903-1850 |
Second Address | Hot Springs, AR 71913-6419 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 06/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102475001 | (05) | AR |