Individual
PRABHAKARA REDDY TUKIVAKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
810 NEWMAN DR # A, HELENA, AR 72342-8950
(870) 338-7441
(870) 338-7945
Mailing address
PO BOX 806, HELENA, AR 72342-0806
(870) 338-7441
(870) 338-7945
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R4048
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117462001
—
AR
Enumeration date
09/07/2006
Last updated
12/04/2014
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