Provider Demographics
NPI:1336594191
Name:KOTAPATI, SUJIT KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SUJIT KUMAR
Middle Name:
Last Name:KOTAPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SUJIT
Other - Middle Name:KUMAR
Other - Last Name:KOTAPATI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
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 1:521 JACK STEPHENS DR # 530
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5524
Practice Address - Country:US
Practice Address - Phone:501-686-6560
Practice Address - Fax:501-686-8421
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-14472207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine