Individual
KEERTHI KIRAN PONUGOTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2705 E PINETREE BLVD STE C, THOMASVILLE, GA 31792-4875
(229) 584-5731
(229) 584-5941
Mailing address
2705 E PINETREE BLVD STE C, THOMASVILLE, GA 31792-4875
(229) 584-5731
(229) 584-5941
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
071394
GA
207R00000X
Internal Medicine Physician
4449
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
071394
GA
207RP1001X
Pulmonary Disease Physician
Primary
071394
GA
Other
Enumeration date
06/23/2010
Last updated
08/05/2020
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