Provider Demographics
NPI:1790740025
Name:DR CHALASANI & ASSOC LLC
Entity Type:Organization
Organization Name:DR CHALASANI & ASSOC LLC
Other - Org Name:S RAO CHALASANI MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-767-3278
Mailing Address - Street 1:8542 SIEGEN LN
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1940
Mailing Address - Country:US
Mailing Address - Phone:225-767-3278
Mailing Address - Fax:225-767-3262
Practice Address - Street 1:8542 SIEGEN LN
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1940
Practice Address - Country:US
Practice Address - Phone:225-767-3278
Practice Address - Fax:225-767-3262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0154562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA441571Medicaid
LA441571Medicaid
B89355Medicare UPIN