Provider Demographics
NPI:1003875451
Name:REDDY, NAVEEN (MD)
Entity Type:Individual
Prefix:
First Name:NAVEEN
Middle Name:
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6104
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85261-6104
Mailing Address - Country:US
Mailing Address - Phone:480-820-7246
Mailing Address - Fax:480-897-7246
Practice Address - Street 1:2705 S ALMA SCHOOL RD
Practice Address - Street 2:STE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-4400
Practice Address - Country:US
Practice Address - Phone:480-820-7246
Practice Address - Fax:480-897-7246
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35925207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ137688Medicaid
AZ137688Medicaid
6395660001Medicare NSC