Provider Demographics
NPI:1730523986
Name:HECKLE, KEERTHI GADIPARTHI
Entity type:Individual
Prefix:
First Name:KEERTHI
Middle Name:GADIPARTHI
Last Name:HECKLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 ANGELWOOD CIR E
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-1568
Mailing Address - Country:US
Mailing Address - Phone:901-497-6125
Mailing Address - Fax:
Practice Address - Street 1:1500 W POPLAR AVE STE 202
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017
Practice Address - Country:US
Practice Address - Phone:901-861-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN54695207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine