Sodam, Bali Reddy
Sodam, Bali Reddy is an sole proprietor health care provider with primary practice located at 4417 W Gore Blvd Suite 1, Lawton OK 73505-5978. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Sodam, Bali Reddy can be contacted via phone (580) 536-5273.Contact Information
Primary practice address
4417 W Gore Blvd Suite 1
Lawton OK 73505-5978
Phone: (580) 536-5273
Fax: (580) 357-8500
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 24723 | Oklahoma |
Profile Details
| NPI number | 1689787780 |
|---|---|
| LBN Legal business name | Sodam, Bali Reddy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2006 |
| Last updated | Dec 8th, 2010 - about 15 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 | 1689787780 | NPPES |
| Oklahoma | MEDICAID | 200074670A |
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