Doctor Name: | DR. SRINIVAS POTTURI |
NPI Number: | 1013012103 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D., |
License Number: | MD.200712 |
Business Practice Address: | 510 E Stoner Ave Shreveport, LA - 711014243 |
Business Phone Number: | 3182218411 |
Business Fax Number: | |
Mailing Address: | 189 Captain H.m Blvd., SHREVEPORT |
State: | LA |
Postal Code: | 71115 |
Phone Number: | 3184597557 |
Fax Number: | 3184597557 |
NPI Enumeration Date: | 09/13/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | MD.200712 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |