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General NPI Number Information
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NPI Number | 1548426810
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Entity Type | Individual
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Provider Name | VINAYA K. PUPPALA M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 5505 ROSWELL RD STE 350
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City | ATLANTA
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State | GA
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Zip | 30342-1995
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Country | US
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Telephone | 470-827-3648
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Fax |
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Provider Business Mailing Address
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Address Line | 403 PERMIAN WAY STE D
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City | VILLA RICA
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State | GA
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Zip | 30180-3226
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Country | US
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Telephone | 470-827-3648
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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 | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 71014
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 036126601
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 71014
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License Number State | GA
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