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General NPI Number Information
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NPI Number | 1366467714
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Entity Type | Individual
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Provider Name | KURAPATI BHASKAR REDDY MD, DPM
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 517 COURT ST RM 503
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City | NEILLSVILLE
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State | WI
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Zip | 54456-1976
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Country | US
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Telephone | 715-743-5192
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Fax | 715-743-5209
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Provider Business Mailing Address
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Address Line | 402 SOUTHWOOD CT
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City | EAU CLAIRE
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State | WI
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Zip | 54701-5900
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Country | US
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Telephone | 715-834-2751
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Fax | 715-743-5209
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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 | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 1166
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License Number State | WI
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