Reddy, Praveen K
Reddy, Praveen K is an individual health care provider with primary practice located at 721 River Dr. Suite B, Fort Bragg CA 95437-5403. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Reddy, Praveen K can be contacted via phone (707) 964-6910.Contact Information
Primary practice address
721 River Dr. Suite B
Fort Bragg CA 95437-5403
Phone: (707) 964-6910
Fax: (707) 964-7430
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | C142043 | California |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | H6536 | Texas |
Profile Details
| NPI number | 1255301842 |
|---|---|
| LBN Legal business name | Reddy, Praveen K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2006 |
| Last updated | Oct 6th, 2016 - about 8 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 | 1255301842 | NPPES |
| Texas | MEDICAID | 115606901 |
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