Provider Demographics
NPI:1164031373
Name:REDDY, ROHITH GUDURU VENKATA (MD)
Entity type:Individual
Prefix:
First Name:ROHITH
Middle Name:GUDURU VENKATA
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NORTH SUNFLOWER MEDICAL CENTER, 840 N OAK AVE,
Mailing Address - Street 2:
Mailing Address - City:RULEVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38771
Mailing Address - Country:US
Mailing Address - Phone:662-756-4000
Mailing Address - Fax:
Practice Address - Street 1:NORTH SUNFLOWER MEDICAL CENTER, 840 N OAK AVE
Practice Address - Street 2:
Practice Address - City:RULEVILLE
Practice Address - State:MS
Practice Address - Zip Code:38771
Practice Address - Country:US
Practice Address - Phone:662-756-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS31782207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine