Healthcare Provider Details

I. General information

NPI: 1760539985
Provider Name (Legal Business Name): SREEDHAR RAO BILLAKANTY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 OLENTANGY RIVER RD SUITE 100
COLUMBUS OH
43214-3467
US

IV. Provider business mailing address

1619 SKYLINE CIR STE A
CARLSBAD NM
88220-9842
US

V. Phone/Fax

Practice location:
  • Phone: 614-262-6772
  • Fax: 614-447-2752
Mailing address:
  • Phone: 575-941-4400
  • Fax: 833-620-2406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number35087093
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.087093
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35087093
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: