Provider Demographics
NPI:1134160112
Name:REDDY, ARUNJOTI A (MD)
Entity type:Individual
Prefix:DR
First Name:ARUNJOTI
Middle Name:A
Last Name:REDDY
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:PO BOX 660612
Mailing Address - Street 2:PRIMARY CARE MEDICINE HDL CLINIC LLC
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35266-0612
Mailing Address - Country:US
Mailing Address - Phone:205-788-7988
Mailing Address - Fax:205-780-0883
Practice Address - Street 1:801 PRINCETON AVE SW
Practice Address - Street 2:PROFESSIONAL OFFICE BLDG ONE SUITE 210
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211
Practice Address - Country:US
Practice Address - Phone:205-788-7988
Practice Address - Fax:205-780-0883
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00010084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051503408Medicaid
ALP00120836OtherRR MEDICARE
C73950Medicare UPIN
051503408REDMedicare ID - Type Unspecified