Provider Demographics
NPI:1386708857
Name:RAJ CLINICS PROFESSIONAL SERVICES CORPORATION
Entity type:Organization
Organization Name:RAJ CLINICS PROFESSIONAL SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SITHA GITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALAPATAPU
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DGO
Authorized Official - Phone:574-732-1166
Mailing Address - Street 1:909 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LOGANSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46947-2208
Mailing Address - Country:US
Mailing Address - Phone:574-732-1166
Mailing Address - Fax:574-753-4117
Practice Address - Street 1:6 CHASE PARK
Practice Address - Street 2:
Practice Address - City:LOGANSPORT
Practice Address - State:IN
Practice Address - Zip Code:46947-1553
Practice Address - Country:US
Practice Address - Phone:574-732-1166
Practice Address - Fax:574-753-4117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty