Provider Demographics
NPI:1083142855
Name:KANDREGULA, KRISHNA CHAITANYA (MBBS)
Entity Type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:CHAITANYA
Last Name:KANDREGULA
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
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Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-227-0421
Mailing Address - Fax:501-227-0105
Practice Address - Street 1:9600 BAPTIST HEALTH DR STE 320
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6322
Practice Address - Country:US
Practice Address - Phone:501-227-0421
Practice Address - Fax:501-227-0105
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-156272084V0102X
OH35.1421892084V0102X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology