Organization
REGIONAL INFECTIOUS DISEASES AND INFUSION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVI KAMEPALLI M.D. (PHYSICIAN/OWNER)
(567) 204-0745
Entity
Organization
Contact information
Practice address
505 JENKINS ST, LAGRANGE, GA 30240-4225
(706) 739-7789
(706) 739-7789
Mailing address
505 JENKINS ST, LAGRANGE, GA 30240-4225
(567) 204-0745
(706) 739-7789
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
35066788
OH
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003232464I
—
GA
01
—
G187324214
MEDICARE
GA
Enumeration date
07/03/2006
Last updated
05/05/2023
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