Provider Demographics
NPI:1386064384
Name:REDDY, KRISHNA INTA ANANTA (MD, MCH, FRCS(ORTH))
Entity type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:INTA ANANTA
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD, MCH, FRCS(ORTH)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SEAMAN
Mailing Address - State:OH
Mailing Address - Zip Code:45679-8002
Mailing Address - Country:US
Mailing Address - Phone:937-386-3400
Mailing Address - Fax:
Practice Address - Street 1:230 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:SEAMAN
Practice Address - State:OH
Practice Address - Zip Code:45679-8002
Practice Address - Country:US
Practice Address - Phone:937-386-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.129427207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty