Healthcare Provider Details

I. General information

NPI: 1255713616
Provider Name (Legal Business Name): KEERTHI REDDY PADOORU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2015
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 COVINGTON HWY
DECATUR GA
30032-2643
US

IV. Provider business mailing address

6325 HOSPITAL PKWY
JOHNS CREEK GA
30097-5775
US

V. Phone/Fax

Practice location:
  • Phone: 404-383-1300
  • Fax:
Mailing address:
  • Phone: 678-474-7038
  • Fax: 678-474-7033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number86441
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number86441
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: