Healthcare Provider Details

I. General information

NPI: 1134481971
Provider Name (Legal Business Name): RAMAKRISHNA KASINDULA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 AMBASSADOR CAFFERY PKWY STE B130
LAFAYETTE LA
70508-6959
US

IV. Provider business mailing address

302 HACKER ST
NEW IBERIA LA
70560-4508
US

V. Phone/Fax

Practice location:
  • Phone: 337-981-8486
  • Fax: 337-988-6816
Mailing address:
  • Phone: 376-088-9883
  • Fax: 337-417-9909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number099324
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: