| Reddy Valadri Primary Care | |
|
6211 Thomaston Rd Macon GA 31220-7702 | |
| (404) 200-1373 | |
| Not Available |
| Full Name | Reddy Valadri Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 6211 Thomaston Rd, Macon, Georgia |
| Authorized Official Name and Position | Ravinder Valadri (DIRECTOR) |
| Authorized Official Contact | 4042001373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reddy Valadri Primary Care 134 Aston Hall Macon GA 31210-1400 Ph: (404) 200-1373 | Reddy Valadri Primary Care 6211 Thomaston Rd Macon GA 31220-7702 Ph: (404) 200-1373 |
| NPI Number | 1417656422 |
|---|---|
| Provider Enumeration Date | 02/28/2023 |
| Last Update Date | 02/28/2023 |
| Medicare PECOS PAC ID | 5193180388 |
|---|---|
| Medicare Enrollment ID | O20230421001603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417656422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Linda S Phegley-payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942676416 PECOS PAC ID: 3375843436 Enrollment ID: I20151123001462 |
| Provider Name | Radhika Reddy Gadesam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427285006 PECOS PAC ID: 3870749021 Enrollment ID: I20190908000016 |
| Provider Name | Ravinder R Valadri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255770368 PECOS PAC ID: 4486877404 Enrollment ID: I20200824001926 |
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