Individual
DR. SWETHA JALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7926 PRESTON HWY STE 106, LOUISVILLE, KY 40219-3848
(029) 644-3575
(502) 966-5948
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01086247A
IN
207Q00000X
Family Medicine Physician
53021
KY
207Q00000X
Family Medicine Physician
R4318
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068010713
MEDICARE
IN
01
—
264430C92
MEDICARE
IN
05
—
300024282
—
IN
05
—
7100498700
—
KY
01
—
K285420
KY MEDICARE
KY
Enumeration date
04/25/2016
Last updated
02/23/2023
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