Individual
SUDHA PRASAD JAGANATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
711 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3439
(859) 287-3045
(859) 578-3800
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 301-0124
(859) 301-0699
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.090787
OH
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
01090936A
IN
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
58033
KY
207RC0000X
Cardiovascular Disease Physician
58033
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2873412
—
OH
Enumeration date
11/29/2006
Last updated
06/26/2025
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