Individual
MS. AKHILA TAKKALLAPALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 TARA COMMONS DR, LOGANVILLE, GA 30052-8018
(678) 928-9700
Mailing address
101 TARA COMMONS DR, LOGANVILLE, GA 30052-8018
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
04/23/2014
Last updated
11/12/2019
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