Provider Demographics
NPI:1487802609
Name:REDDY, KRISHNA PAIDA (MD)
Entity type:Individual
Prefix:
First Name:KRISHNA
Middle Name:PAIDA
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 CAMP CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CROPWELL
Mailing Address - State:AL
Mailing Address - Zip Code:35054-5100
Mailing Address - Country:US
Mailing Address - Phone:205-525-0305
Mailing Address - Fax:
Practice Address - Street 1:2904 CAMP CREEK RD
Practice Address - Street 2:
Practice Address - City:CROPWELL
Practice Address - State:AL
Practice Address - Zip Code:35054-5100
Practice Address - Country:US
Practice Address - Phone:205-525-0305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4508204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM