Individual
MADAN MOHAN REDDY KOPPOLU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
309 JACKSON ST, MONROE, LA 71201-7407
(318) 966-4000
Mailing address
8312 MISTY CREEK DR, GERMANTOWN, TN 38138-7604
(520) 906-7591
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
51854
TN
208M00000X
Hospitalist Physician
MD204817
LA
Other
Enumeration date
08/18/2008
Last updated
08/15/2024
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