Individual
PADMAJA SANAPUREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N STATE ST, FAMILY MEDICINE, SLEEP MEDICINE, JACKSON, MS 39216-4500
(601) 815-4778
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-4778
(601) 984-5420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23686
MS
207QS1201X
Sleep Medicine (Family Medicine) Physician
Primary
23686
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04129381
—
MS
01
—
P01500396
RR MEDICARE
MS
Enumeration date
07/06/2011
Last updated
07/12/2016
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