| Crisp Medical And Kidney Care Llc | |
|
401 E 4th Ave Cordele GA 31015-3620 | |
| (478) 953-0024 | |
| (478) 953-0675 |
| Full Name | Crisp Medical And Kidney Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 401 E 4th Ave, Cordele, Georgia |
| Authorized Official Name and Position | Srilatha Nadipineni (MD OWNER) |
| Authorized Official Contact | 4789530024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crisp Medical And Kidney Care Llc 401 E 4th Ave Cordele GA 31015-3620 Ph: (478) 953-0024 | Crisp Medical And Kidney Care Llc 401 E 4th Ave Cordele GA 31015-3620 Ph: (478) 953-0024 |
| NPI Number | 1407606379 |
|---|---|
| Provider Enumeration Date | 03/25/2024 |
| Last Update Date | 03/25/2024 |
| Medicare PECOS PAC ID | 1456792001 |
|---|---|
| Medicare Enrollment ID | O20240514000422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407606379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Secondary |
| Provider Name | Srilatha Nadipineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073720496 PECOS PAC ID: 9931388386 Enrollment ID: I20110525000583 |
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