Provider Demographics
NPI:1568647253
Name:UDAYASANKAR, UNNI K (MD)
Entity Type:Individual
Prefix:DR
First Name:UNNI
Middle Name:K
Last Name:UDAYASANKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5048 N VIA VELAZQUEZ
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-5999
Mailing Address - Country:US
Mailing Address - Phone:404-387-2410
Mailing Address - Fax:
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-626-1069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-01
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0953452085N0700X, 2085P0229X
GA0023092085B0100X
AZ498962085P0229X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging