Koritala, Chandra S
Koritala, Chandra S is an individual health care provider with primary practice located at 11408 Lake Sherwood Ave N Ste A , Baton Rouge LA 70816-0421. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Koritala, Chandra S can be contacted via phone (225) 754-9478.Contact Information
Primary practice address
11408 Lake Sherwood Ave N Ste A
Baton Rouge LA 70816-0421
Phone: (225) 754-9478
Fax: (225) 659-8033
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 11870R | Louisiana |
Profile Details
| NPI number | 1295796308 |
|---|---|
| LBN Legal business name | Koritala, Chandra S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2006 |
| Last updated | Mar 21st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295796308 | NPPES |
| Louisiana | MEDICAID | 1686441 |
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