Basic Information
| Provider Information | |||||||||
| NPI: | 1205158250 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INTERNAL MEDICINE ASSOCIATES OF OCALA PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1623 SW 1ST AVE | ||||||||
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| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344716528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527329844 | ||||||||
| FaxNumber: | 3527325497 | ||||||||
| Practice Location | |||||||||
| Address1: | 9401 SW HIGHWAY 200 | ||||||||
| Address2: | BUILDING 500, SUITE 502 | ||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344819612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527329844 | ||||||||
| FaxNumber: | 3527325497 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2010 | ||||||||
| LastUpdateDate: | 02/18/2010 | ||||||||
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| AuthorizedOfficialLastName: | REDDY | ||||||||
| AuthorizedOfficialFirstName: | KUCHAKULLA | ||||||||
| AuthorizedOfficialMiddleName: | N | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3524820296 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.