Provider Demographics
NPI:1376120329
Name:YAKKANTI, RUKMINI KRISHNAKANTH REDDY (DO)
Entity Type:Individual
Prefix:
First Name:RUKMINI
Middle Name:KRISHNAKANTH REDDY
Last Name:YAKKANTI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7103 WINDHAM PKWY
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-8806
Mailing Address - Country:US
Mailing Address - Phone:502-640-6650
Mailing Address - Fax:
Practice Address - Street 1:303 LANGDON ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2750
Practice Address - Country:US
Practice Address - Phone:606-451-5092
Practice Address - Fax:606-451-5087
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program