Healthcare Provider Details

I. General information

NPI: 1033207550
Provider Name (Legal Business Name): LALITHA VADDADI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 WINCHESTER RD
MEMPHIS TN
38118-9007
US

IV. Provider business mailing address

2018 WOODCHASE CV
CORDOVA TN
38016-5081
US

V. Phone/Fax

Practice location:
  • Phone: 901-369-1420
  • Fax: 901-369-1433
Mailing address:
  • Phone: 901-369-1480
  • Fax: 901-369-1452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD18630
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberMD18630
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD18630
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberMD18630
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: