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NPI Code Detail

MEDICARE: KISHORE GADIKOTA M.D.

MEDICARE: KISHORE GADIKOTA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician47119KY
2208000000XPediatrics PhysicianMD18839ME
3208000000XPediatrics PhysicianR9062TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366616583
Entity Type Code : Individual
Provider Name (Legal Business Name) : KISHORE GADIKOTA M.D.
Provider Business Mailing Address
First Line : PO BOX 432
Second Line :
City : PIKEVILLE
State : KY
Zip : 41502-0432
Country : US
Telephone Number : 606-430-2230
Fax Number : 606-437-2526
Provider Business Practice Location Address
First Line : 5655 W SPRING CREEK PKWY STE 200
Second Line :
City : PLANO
State : TX
Zip : 75024-4175
Country : US
Telephone Number : 214-473-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2008
Last Update Date : 12/16/2025

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Directions to “ KISHORE GADIKOTA M.D.” Practice Location

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