Provider Demographics
NPI:1124279427
Name:KODURI, NARAYANA MURTY (MD)
Entity type:Individual
Prefix:DR
First Name:NARAYANA
Middle Name:MURTY
Last Name:KODURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:600 E FRANCIS ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6796
Mailing Address - Country:US
Mailing Address - Phone:308-696-7251
Mailing Address - Fax:308-532-4299
Practice Address - Street 1:600 E FRANCIS ST
Practice Address - Street 2:SUITE 8
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6796
Practice Address - Country:US
Practice Address - Phone:308-696-7251
Practice Address - Fax:308-532-4299
Is Sole Proprietor?:No
Enumeration Date:2008-10-05
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE265402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025598700Medicaid
NE10025598700Medicaid