Provider Demographics
NPI:1821774282
Name:PANTHANGI, VENKATESH
Entity type:Individual
Prefix:
First Name:VENKATESH
Middle Name:
Last Name:PANTHANGI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 AVALON AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-2805
Mailing Address - Country:US
Mailing Address - Phone:256-386-4940
Mailing Address - Fax:256-386-4929
Practice Address - Street 1:203 AVALON AVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2869
Practice Address - Country:US
Practice Address - Phone:256-386-4940
Practice Address - Fax:256-386-4929
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL521452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry