Provider Demographics
NPI:1700307956
Name:KOTAPATI, VENKATA LAKSHMI PRASANNA
Entity type:Individual
Prefix:DR
First Name:VENKATA LAKSHMI
Middle Name:PRASANNA
Last Name:KOTAPATI
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:VENKATA LAKSHMI
Other - Middle Name:PRASANNA
Other - Last Name:MADDUKURI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4904 MOUNTAIN LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-1971
Mailing Address - Country:US
Mailing Address - Phone:914-826-0153
Mailing Address - Fax:
Practice Address - Street 1:800 OAK ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-1199
Practice Address - Country:US
Practice Address - Phone:434-200-5203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101268833208M00000X, 207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist