MEDICARE: DR. VENU BABU KAKARALA MD

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
1	261QR1300X	Rural Health Clinic/Center	13643R	LA
2	207R00000X	Internal Medicine Physician	13643R	LA

Other Identifiers

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

General Provider Information

NPI Number	:	1538166822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VENU BABU KAKARALA MD

Provider Business Mailing Address
First Line	:	1169 HIGHWAY 19 STE B
Second Line	:
City	:	SLAUGHTER
State	:	LA
Zip	:	70777-3404
Country	:	US
Telephone Number	:	225-570-2257
Fax Number	:	225-286-4078

Provider Business Practice Location Address
First Line	:	1169 HIGHWAY 19 STE B
Second Line	:
City	:	SLAUGHTER
State	:	LA
Zip	:	70777-3404
Country	:	US
Telephone Number	:	225-570-2257
Fax Number	:	225-286-4078

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	01/25/2022

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