Individual
SRIDHAR JATLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2330 S DIXON RD STE 325, KOKOMO, IN 46902-6430
(765) 455-8822
(765) 865-3935
Mailing address
6983 HILLSDALE CT, INDIANAPOLIS, IN 46250-2054
(317) 849-8350
(317) 576-6311
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
01063214A
IN
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
01063214A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200903530
—
IN
Enumeration date
08/05/2006
Last updated
02/27/2025
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