Provider Demographics
NPI:1720006059
Name:NAIDU, LAKSHMI RANI (MD)
Entity Type:Individual
Prefix:
First Name:LAKSHMI
Middle Name:RANI
Last Name:NAIDU
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 1:100 E LIBERTY ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1434
Mailing Address - Country:US
Mailing Address - Phone:859-276-4486
Mailing Address - Fax:859-277-9164
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:SUITE B160
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3751
Practice Address - Country:US
Practice Address - Phone:859-276-4486
Practice Address - Fax:859-277-9164
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35286207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64028806Medicaid
KY64028806Medicaid
KYK023493Medicare PIN
CB5773OtherRR MEDICARE GROUP
KY4000501OtherMEDICARE LAB GROUP
H08641Medicare UPIN
OH4320191Medicare PIN
110220286OtherRR MEDICARE PIN