Penukonda, Sasi Kiran

Penukonda, Sasi Kiran is an individual health care provider with primary practice located at 2032 Elizabeth Ave , Shreveport LA 71104-2123. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Endocrinology. Allopathic & Osteopathic Physicians / Pediatric Endocrinology is his primary health care specialty. Penukonda, Sasi Kiran can be contacted via phone (318) 698-0035.

Contact Information

Primary practice address
2032 Elizabeth Ave Shreveport LA 71104-2123
Phone: (318) 698-0035
Fax: (318) 698-0078
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 261269 Massachusetts
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X 325077 Louisiana

Profile Details

NPI number 1811220957
LBN Legal business name Penukonda, Sasi Kiran
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2009
Last updated Jan 9th, 2023 - about last year

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 1811220957 NPPES
Massachusetts MEDICAID 110103822A

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