Individual
DR. BHAGYA LAKSHMI PAPUDESU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8019 DIXIE HWY STE 101, LOUISVILLE, KY 40258-1303
(502) 333-3121
(502) 333-3131
Mailing address
1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
(502) 333-3121
(502) 333-3131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
052613
GA
207R00000X
Internal Medicine Physician
Primary
50072
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052613
PROVIDER MEDICAL LICENSE
GA
01
—
111825
FQHC CMS CERT NUMBER
GA
01
—
111918
FQHC CMS CERT NUMBER
GA
Enumeration date
05/15/2006
Last updated
03/24/2020
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