Individual
PAVANI ELLIPEDDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7777 HENNESSY BLVD STE 6000, BATON ROUGE, LA 70808-4366
(225) 757-0343
(225) 757-8354
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 757-0343
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-35740
KS
207RX0202X
Medical Oncology Physician
Primary
305195
LA
208M00000X
Hospitalist Physician
30365
AL
Other
Enumeration date
11/12/2007
Last updated
10/03/2024
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