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NPI Code Detail

MEDICARE: ASWANTH REDDY

MEDICARE: ASWANTH REDDY
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
1207R00000XInternal Medicine Physician255845MA
2390200000XStudent in an Organized Health Care Education/Training Program
3207RH0003XHematology & Oncology PhysicianE-12889AR

General Provider Information

NPI Number : 1922448075
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASWANTH REDDY
Provider Business Mailing Address
First Line : 7001 ROGERS AVE STE 200
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-4022
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7001 ROGERS AVE STE 200
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-4022
Country : US
Telephone Number : 860-679-4410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2013
Last Update Date : 08/10/2020

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Directions to “ ASWANTH REDDY ” Practice Location

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