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General NPI Number Information
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NPI Number | 1790836252
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Entity Type | Individual
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Provider Name | RANGADHAM NAGARAKANTI MD
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 269 S CANDY LN
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4158
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Country | US
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Telephone | 928-634-1331
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 N BEAVER ST ATTN: PAYER CREDENTIALING
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3118
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Country | US
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Telephone | 928-213-6235
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Fax | 928-213-6292
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MA08495300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 67092
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD202854
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 48585
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | R3562
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 48585
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License Number State | KY
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 48585
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License Number State | KY
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Taxonomy #8
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD424922
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License Number State | PA
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Taxonomy #9
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD424922
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License Number State | PA
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