Individual
PRAKASH PEDDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
203753
LA
207RH0003X
Hematology & Oncology Physician
Primary
203753
LA
Other
Enumeration date
05/25/2007
Last updated
07/24/2013
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