Individual
DR. KOTESWARA R POTHINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7777 HENNESSY BLVD STE 1000, BATON ROUGE, LA 70808-4370
(225) 767-3900
(225) 766-2226
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4431
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
27587
AL
207RC0000X
Cardiovascular Disease Physician
204177
LA
207RI0011X
Interventional Cardiology Physician
Primary
204177
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08154048
—
MS
05
—
2107364
—
LA
01
—
351459YUST
MEDICARE PTAN
LA
Enumeration date
10/09/2007
Last updated
03/07/2023
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