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Individual

DR. KOTESWAR RAO SUREDDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1400 BRYAN DR, SUITE 300, DURANT, OK 74702
(580) 924-1700
(580) 924-1736
Mailing address
1400 BRYAN DR, SUITE 300, DURANT, OK 74702
(580) 924-1700
(580) 924-1736

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11978
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100014110A
OK
Enumeration date
06/02/2006
Last updated
09/07/2012
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