Individual
DR. GEETHA R KOMATIREDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3098 OAK GROVE RD, POPLAR BLUFF, MO 63901-1908
(573) 727-0551
(573) 727-9190
Mailing address
PO BOX 405461, ATLANTA, GA 30384-5461
(573) 727-0551
(573) 727-9190
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
E4716
AR
207RR0500X
Rheumatology Physician
Primary
R3N00
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20316800
—
MO
Enumeration date
07/02/2006
Last updated
09/09/2020
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