Mallepalli Md A Professional | |
2408 Duval Dr Ste 2 Monroe LA 71201-2986 | |
(318) 388-8561 | |
(318) 388-8564 |
Full Name | Mallepalli Md A Professional |
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Speciality | Clinic/Center |
Location | 2408 Duval Dr Ste 2, Monroe, Louisiana |
Authorized Official Name and Position | Venkat N. Mallepalli (PRESIDENT) |
Authorized Official Contact | 3183888561 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mallepalli Md A Professional 2408 Duval Dr Ste 2 Monroe LA 71201-2986 Ph: (318) 388-8561 | Mallepalli Md A Professional 2408 Duval Dr Ste 2 Monroe LA 71201-2986 Ph: (318) 388-8561 |
NPI Number | 1447374921 |
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Provider Enumeration Date | 03/19/2007 |
Last Update Date | 06/26/2019 |
Medicare PECOS PAC ID | 4789678012 |
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Medicare Enrollment ID | O20040412000213 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447374921 | NPI | - | NPPES |
1536199 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | 12443R (Louisiana) | Primary |
Provider Name | Venkat N Mallepalli |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1265546527 PECOS PAC ID: 4981697430 Enrollment ID: I20040408000427 |
Integrated Health Services Incorporated Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2101 Tower Dr, Monroe, LA 71201 Phone: 318-410-1044 | |
David L. Barnes, Md, Apmc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3400 Medical Park Dr, Suite C, Monroe, LA 71203 Phone: 318-325-6078 Fax: 318-324-9694 | |
J Dean Stockstill Md, A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3510 Magnolia Cv, Suite 190, Monroe, LA 71203 Phone: 318-323-7576 Fax: 318-322-7131 | |