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Individual

DR. THEJOVATHI EDALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
4301 W MARKHAM ST, SLOT # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-6562
Mailing address
1501 RAHLING RD APT 702, LITTLE ROCK, AR 72223-4656

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E-9656
AR
207LP3000X
Pediatric Anesthesiology Physician
E-9656
AR

Other

Enumeration date
10/12/2011
Last updated
01/23/2017
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