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General NPI Number Information
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NPI Number | 1295752160
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Entity Type | Individual
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Provider Name | PRAVEEN K PONNAMREDDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 825 NE 10TH ST # 2E
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5417
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Country | US
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Telephone | 405-271-7001
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Fax | 405-271-7034
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Provider Business Mailing Address
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Address Line | 825 NE 10TH ST # 2E
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5417
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Country | US
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Telephone | 405-271-7001
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Fax | 405-271-7034
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 229636
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 45006
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 207RH0005X
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Taxonomy Name | Hypertension Specialist Physician
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License Number | 229636
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 229636
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 45006
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License Number State | OK
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Taxonomy #6
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 16872
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License Number State | NH
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