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General NPI Number Information
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NPI Number | 1164478772
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Entity Type | Individual
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Provider Name | JHANSI L KODURI MD
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Gender | Female
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 1029 WHISPERING PINE LN
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City | DAYTON
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State | OH
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Zip | 45458-6061
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Country | US
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Telephone | 937-286-2638
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Fax |
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Provider Business Mailing Address
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Address Line | 1029 WHISPERING PINE LN
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City | DAYTON
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State | OH
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Zip | 45458-6061
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Country | US
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Telephone | 937-286-2638
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 35084381
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License Number State | OH
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