Individual
DR. NANDAKISHORE DUKKIPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 MEDICAL DR, BLYTHEVILLE, AR 72315-1425
(870) 762-6725
Mailing address
608 S ESTATE DR, BLYTHEVILLE, AR 72315-8005
(870) 776-1700
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E-4520
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5N466
BCBS
AR
Enumeration date
06/25/2006
Last updated
07/08/2007
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