Individual
ASHOK KOTA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
806 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102-3657
(505) 842-6575
(505) 764-8796
Mailing address
8801 HORIZON BLVD NE, SUITE 360, ALBUQUERQUE, NM 87113-1533
(505) 828-4923
(505) 213-0103
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD2005-0164
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28353854
—
NM
05
—
956724
—
AZ
01
—
NM009W34
BC BS OF NM
NM
01
—
P00241847
RRB MEDICARE RAILROAD
NM
Enumeration date
10/21/2005
Last updated
04/25/2008
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