Mr Gautham Reddy Kandukuri, MD | |
Po Box 343, Reedsport, OR 97467-0343 | |
(816) 800-9020 | |
Not Available |
Full Name | Mr Gautham Reddy Kandukuri |
---|---|
Gender | Male |
Speciality | Radiology - Vascular & Interventional Radiology |
Location | Po Box 343, Reedsport, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174979462 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0204X | Radiology - Vascular & Interventional Radiology | MD211277 (Oregon) | Secondary |
Entity Name | Grande Ronde Hospital Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467446195 PECOS PAC ID: 0547170789 Enrollment ID: O20031124000758 |
Entity Name | Lower Umpqua Hospital District |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003874819 PECOS PAC ID: 6800703562 Enrollment ID: O20040212000228 |
Entity Name | Bay Area Hospital District |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225016561 PECOS PAC ID: 2163331000 Enrollment ID: O20040310000301 |
Entity Name | Grande Ronde Hospital Inc |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1467446195 PECOS PAC ID: 0547170789 Enrollment ID: O20061104000155 |
Entity Name | Baker Community Health Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396807319 PECOS PAC ID: 3779689807 Enrollment ID: O20190201002544 |
Entity Name | Greator Missouri Imaging Associates Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851144539 PECOS PAC ID: 0244777316 Enrollment ID: O20240930001683 |
Entity Name | Inspire Radiology Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487485181 PECOS PAC ID: 2365975216 Enrollment ID: O20241030003301 |
Mailing Address | Practice Location Address |
---|---|
Mr Gautham Reddy Kandukuri, MD 2301 Holmes Street, Kansas City, MO 64108 Ph: (816) 404-4175 | Mr Gautham Reddy Kandukuri, MD Po Box 343, Reedsport, OR 97467-0343 Ph: (816) 800-9020 |