Organization
SREENIVASA RAO TADIKONDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SREENIVASA TADIKONDA MD (OWNER/PROVIDER)
(318) 547-0466
Entity
Organization
Contact information
Practice address
1401 EZELLE ST, RUSTON, LA 71270-7218
(318) 251-3126
Mailing address
120 PALEO DR, MONROE, LA 71203-8844
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
05/19/2022
Last updated
05/19/2022
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