Organization
LAWTON NEPHROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BALI REDDY SODAM MD (PROVIDER)
(580) 357-8330
Entity
Organization
Contact information
Practice address
5108 W GORE BLVD, STE 2, LAWTON, OK 73505-6025
(580) 357-8330
Mailing address
5108 W GORE BLVD, STE 2, LAWTON, OK 73505-6025
(580) 357-8330
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
24723
OK
Other
Enumeration date
07/12/2006
Last updated
08/22/2020
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