Provider Demographics
NPI:1083272587
Name:YARLAGADDA, KEERTHI (MD)
Entity Type:Individual
Prefix:
First Name:KEERTHI
Middle Name:
Last Name:YARLAGADDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4062 PEACHTREE RD NE STE C
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3021
Mailing Address - Country:US
Mailing Address - Phone:404-365-6500
Mailing Address - Fax:404-365-6501
Practice Address - Street 1:4062 PEACHTREE RD NE STE C
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-3021
Practice Address - Country:US
Practice Address - Phone:404-365-6500
Practice Address - Fax:404-365-6501
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT217966207Q00000X
GA92249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine