Provider Demographics
NPI:1487679478
Name:REDDY, RAVINDRA R (MD)
Entity Type:Individual
Prefix:
First Name:RAVINDRA
Middle Name:R
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3520 GENERAL DEGAULLE DR
Mailing Address - Street 2:SUITE 4098
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6757
Mailing Address - Country:US
Mailing Address - Phone:504-362-8046
Mailing Address - Fax:504-362-2215
Practice Address - Street 1:3520 GENERAL DEGAULLE DR
Practice Address - Street 2:SUITE 4098
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6757
Practice Address - Country:US
Practice Address - Phone:504-362-8046
Practice Address - Fax:504-362-2215
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2010-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA15088R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA273829308OtherTIN