Provider Demographics
NPI:1548455900
Name:THIRUKONDA, VENU KARTHIK (MD)
Entity type:Individual
Prefix:DR
First Name:VENU
Middle Name:KARTHIK
Last Name:THIRUKONDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1514 VERNON RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-4131
Mailing Address - Country:US
Mailing Address - Phone:706-812-2426
Mailing Address - Fax:706-845-2427
Practice Address - Street 1:1514 VERNON RD
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240
Practice Address - Country:US
Practice Address - Phone:706-812-2426
Practice Address - Fax:706-845-2427
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT26128207RH0003X
GA83398207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology