Provider Demographics
NPI:1639185473
Name:PADIGALA, KIRAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRAN
Middle Name:K
Last Name:PADIGALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5131 ODONOVAN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4791
Mailing Address - Country:US
Mailing Address - Phone:225-767-4893
Mailing Address - Fax:225-767-5494
Practice Address - Street 1:5131 ODONOVAN DR STE 100
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4791
Practice Address - Country:US
Practice Address - Phone:225-767-4893
Practice Address - Fax:225-767-5494
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT181547207RN0300X
LAMD.204304207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02821221Medicaid
LA2133012Medicaid
LA4P7786629Medicare PIN