Organization
GEETHA REDDY, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEETHA REDDY MD (OWNER)
(870) 864-4189
Entity
Organization
Contact information
Practice address
700 W GROVE ST, EL DORADO, AR 71730-4416
(870) 864-4189
(870) 864-4191
Mailing address
PO BOX 10277, EL DORADO, AR 71730-0001
(870) 864-4189
(870) 864-4191
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
E4716
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161946001
—
AR
01
—
5N641
BLUE CROSS BLUE SHIELD
AR
Enumeration date
07/08/2006
Last updated
07/16/2008
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