Individual
DR. VENUMADHAV REDDY KOTLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 297-5700
(770) 718-1877
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(702) 975-7007
(770) 718-1877
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
79570
GA
207RH0000X
Hematology (Internal Medicine) Physician
C1-0025235
DE
207RH0003X
Hematology & Oncology Physician
44706
TN
207RX0202X
Medical Oncology Physician
Primary
79570
GA
207RX0202X
Medical Oncology Physician
C1-0025235
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1514694
—
TN
01
—
4236662
BCBS
TN
05
—
7100070430
—
KY
Enumeration date
05/27/2008
Last updated
08/08/2022
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