=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326072687
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NARAYAN C REDDY MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2006
-----------------------------------------------------
Last Update Date | 12/07/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2200 PHILADELPHIA DR 548
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45406-1840
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-424-3883
-----------------------------------------------------
Fax | 937-424-3885
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2200 PHILADELPHIA DR 548
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45406-1840
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-424-3883
-----------------------------------------------------
Fax | 937-424-3885
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | 043206
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------