Individual
PRASAD RAO K.D. PADALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 FORT ROOTS DR, 3J/NLR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-2503
(501) 257-2501
Mailing address
2200 FORT ROOTS DR, 3J/NLR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-2503
(501) 257-2501
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
E-7269
AR
2084P0800X
Psychiatry Physician
22329
NE
2084P0800X
Psychiatry Physician
Primary
E-7269
AR
2084P0805X
Geriatric Psychiatry Physician
E-7269
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47078557539
—
NE
Enumeration date
05/10/2006
Last updated
04/20/2012
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