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General NPI Number Information
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NPI Number | 1407816986
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Entity Type | Individual
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Provider Name | AKAVARAM N REDDY MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 1308 8TH ST STE 1
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City | RUPERT
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State | ID
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Zip | 83350-1535
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Country | US
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Telephone | 208-436-4322
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Fax | 208-436-1312
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Provider Business Mailing Address
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Address Line | 8216 HUNTERS GROVE RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7205
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Country | US
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Telephone | 208-421-2347
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | M-9605
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD27896
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License Number State | ME
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