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NPI Code Detail

MEDICARE: DR. VINISHA REDDY KOTA M.D.

MEDICARE: DR. VINISHA REDDY KOTA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RR0500XRheumatology PhysicianE-11807AR

General Provider Information

NPI Number : 1992124291
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VINISHA REDDY KOTA M.D.
Provider Business Mailing Address
First Line : 3500 SPRINGHILL DR STE 200A
Second Line : SUITE 200 A
City : NORTH LITTLE ROCK
State : AR
Zip : 72117-2948
Country : US
Telephone Number : 501-945-0392
Fax Number : 501-945-0394
Provider Business Practice Location Address
First Line : 3500 SPRINGHILL DR STE 200A
Second Line : SUITE 200 A
City : NORTH LITTLE ROCK
State : AR
Zip : 72117-2948
Country : US
Telephone Number : 501-945-0392
Fax Number : 501-945-0394
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2014
Last Update Date : 05/14/2020

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