Provider Demographics
NPI:1457880650
Name:KARRA, ANUSHA REDDY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANUSHA REDDY
Middle Name:
Last Name:KARRA
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 803929
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-3929
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:112 W ROSS BLVD STE A
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801
Practice Address - Country:US
Practice Address - Phone:620-371-7010
Practice Address - Fax:620-371-7011
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-09
Last Update Date:2024-03-19
Deactivation Date:2018-01-11
Deactivation Code:
Reactivation Date:2018-02-21
Provider Licenses
StateLicense IDTaxonomies
KS04-43531207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine