Provider Demographics
NPI:1760779979
Name:OBULAREDDY, SRI J (MD)
Entity Type:Individual
Prefix:DR
First Name:SRI
Middle Name:J
Last Name:OBULAREDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-5148
Practice Address - Street 1:808 N 39TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-6388
Practice Address - Country:US
Practice Address - Phone:509-574-3400
Practice Address - Fax:509-574-3464
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND13992207RX0202X
ARE-15874207R00000X, 207RX0202X
TXBP20049352207RX0202X
WAMD60793231207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine