Provider Demographics
NPI:1518970672
Name:S L PRASAD BABU MD
Entity Type:Organization
Organization Name:S L PRASAD BABU MD
Other - Org Name:PROFESSIONAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAJJA
Authorized Official - Middle Name:L PRASAD
Authorized Official - Last Name:BABU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-324-5335
Mailing Address - Street 1:708 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-3349
Mailing Address - Country:US
Mailing Address - Phone:219-324-5335
Mailing Address - Fax:219-324-5335
Practice Address - Street 1:708 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-3349
Practice Address - Country:US
Practice Address - Phone:219-324-5335
Practice Address - Fax:219-324-5335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty