Provider Demographics
NPI:1437572765
Name:SANKEPALLI, DEEPTHI (MD)
Entity Type:Individual
Prefix:
First Name:DEEPTHI
Middle Name:
Last Name:SANKEPALLI
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 1:2530 BERT KOUNS INDUSTRIAL LOOP STE 113
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-3153
Mailing Address - Country:US
Mailing Address - Phone:318-272-5811
Mailing Address - Fax:318-212-5844
Practice Address - Street 1:2530 BERT KOUNS INDUSTRIAL LOOP STE 113
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118
Practice Address - Country:US
Practice Address - Phone:318-272-5811
Practice Address - Fax:318-212-5844
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LAFS88625612080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program