Individual
RAVI KANAGALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
433 PLAZA ST STE 514, BOGALUSA, LA 70427-3729
(985) 730-7023
Mailing address
PO BOX 1705, MANDEVILLE, LA 70470-1705
(985) 871-8227
(985) 871-6920
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
201805
LA
207RC0001X
Clinical Cardiac Electrophysiology Physician
201805
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04155584
—
MS
05
—
1031569
—
LA
Enumeration date
11/07/2005
Last updated
01/04/2022
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