Provider Demographics
NPI:1851977227
Name:POLISETTY, HARIKA LAKSHMI (MBBS)
Entity type:Individual
Prefix:DR
First Name:HARIKA
Middle Name:LAKSHMI
Last Name:POLISETTY
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1233 W POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-4245
Mailing Address - Country:US
Mailing Address - Phone:479-636-9235
Mailing Address - Fax:479-631-0374
Practice Address - Street 1:1233 W POPLAR ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-4245
Practice Address - Country:US
Practice Address - Phone:479-636-9235
Practice Address - Fax:479-631-0374
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-18686207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine