Individual
DR. CHALLORI J. REDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2007 OCILLA RD, DOUGLAS, GA 31533-2229
(912) 384-0162
(912) 384-4863
Mailing address
PO BOX 14804, BELFAST, ME 04915
(912) 384-1477
(912) 384-1470
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
029936
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00346717A
—
GA
01
—
029936
STATE LICENSE NUMBER
GA
Enumeration date
08/09/2006
Last updated
04/11/2018
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