Balaji, Kethandapatti Chakravarthy

Balaji, Kethandapatti Chakravarthy is an individual health care provider with primary practice located at 655 W 8Th St , Jacksonville FL 32209-6511. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Balaji, Kethandapatti Chakravarthy can be contacted via phone (904) 383-1016.

Contact Information

Primary practice address
655 W 8Th St Jacksonville FL 32209-6511
Phone: (904) 383-1016
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 2010-01458 North Carolina
Allopathic & Osteopathic Physicians / Urology 208800000X ME137242 Florida

Profile Details

NPI number 1558314484
LBN Legal business name Balaji, Kethandapatti Chakravarthy
Credentials MBBS
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Nov 14th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558314484 NPPES
North Carolina MEDICAID 5915217

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