Provider Demographics
NPI:1760654990
Name:BEEMIDI, VIKRAM REDDY
Entity Type:Individual
Prefix:
First Name:VIKRAM
Middle Name:REDDY
Last Name:BEEMIDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 OHIO AVENUE
Mailing Address - Street 2:SUITE 2H
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-9130
Mailing Address - Country:US
Mailing Address - Phone:662-627-3003
Mailing Address - Fax:662-627-3014
Practice Address - Street 1:785 OHIO AVE
Practice Address - Street 2:SUITE 2H
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-6217
Practice Address - Country:US
Practice Address - Phone:662-627-3003
Practice Address - Fax:662-627-3014
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21908207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology