Provider Demographics
NPI:1114263746
Name:G.S,RAO,M.D,P.C
Entity Type:Organization
Organization Name:G.S,RAO,M.D,P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GORANTLA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-881-1111
Mailing Address - Street 1:1425 WEATHERLY RD SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-1178
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1425 WEATHERLY RD SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35803-1178
Practice Address - Country:US
Practice Address - Phone:256-881-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-01
Last Update Date:2019-11-19
Deactivation Date:2019-11-14
Deactivation Code:
Reactivation Date:2019-11-19
Provider Licenses
StateLicense IDTaxonomies
AL8243261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center