Organization
P. REDDY TUKIVAKALA, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEILA A. PRIVETT (OFFICE MANAGER)
(870) 338-7441
Entity
Organization
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
261QP2300X
Primary Care Clinic/Center
Primary
R4048
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119045002
—
AR
01
—
5B386
BLUE CROSS
AR
Enumeration date
03/19/2007
Last updated
07/02/2009
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