Individual
VIJAYALAKSHMI KASUNGANTI RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3000 ASH AVE, PEWEE VALLEY, KY 40056
(502) 241-8454
(502) 241-3067
Mailing address
1502 AUTUMN RIDGE RD, LOUISVILLE, KY 40242-3815
(502) 742-3878
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
38016
KY
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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