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General NPI Number Information
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NPI Number | 1134865868
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Entity Type | Individual
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Provider Name | NAGESHWAR REDDY KOTHUR MD
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Gender | Male
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 601 SOUTH 8TH STREET
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City | GRIFFIN
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State | GA
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Zip | 30224
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Country | US
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Telephone | 770-228-2721
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 N ELM ST
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City | HENDERSON
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State | KY
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Zip | 42420-2783
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Country | US
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Telephone | 270-827-7700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 60106
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License Number State | KY
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