Individual
SRIKANTH KOTTAPALLY REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4812 S 109TH EAST AVE, SUITE 300, TULSA, OK 74146-5826
(918) 392-1400
(918) 236-4587
Mailing address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1400
(918) 392-1488
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2073307
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100173420C
—
OK
01
—
250012255
RAILROAD MEDICARE
OK
01
—
P00216400
RAILROAD MEDICARE
OK
Enumeration date
06/26/2006
Last updated
02/21/2017
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