Provider Demographics
NPI:1336934538
Name:KARROTHU, VISHNU VARDHAN
Entity type:Individual
Prefix:
First Name:VISHNU VARDHAN
Middle Name:
Last Name:KARROTHU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8595 PICARDY AVENUE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-819-1129
Mailing Address - Fax:225-442-5128
Practice Address - Street 1:3401 NORTH BOULEVARD, BRG MID CITY MEDICINE CLINIC
Practice Address - Street 2:SUITE 130
Practice Address - City:BATON ROGUE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-387-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program