Provider Demographics
NPI:1851346845
Name:KAKARLAPUDI, VENKATA V (MD)
Entity Type:Individual
Prefix:
First Name:VENKATA
Middle Name:V
Last Name:KAKARLAPUDI
Suffix:
Gender:M
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:PO BOX 950116
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0116
Mailing Address - Country:US
Mailing Address - Phone:502-893-0159
Mailing Address - Fax:502-213-3853
Practice Address - Street 1:2125 STATE STREET
Practice Address - Street 2:SUITE 6
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4972
Practice Address - Country:US
Practice Address - Phone:812-945-3557
Practice Address - Fax:812-206-1784
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057349A207Y00000X, 207YX0602X
KY40379174400000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200426020Medicaid
IN265400DMedicare PIN
IN234470BMedicare ID - Type Unspecified
IN200426020Medicaid
KY0124005Medicare PIN