Basic Information
Provider Information
NPI: 1689921017
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAKADIA
FirstName: SUNILKUMAR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
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OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 117287
Address2:  
City: ATLANTA
State: GA
PostalCode: 303687287
CountryCode: US
TelephoneNumber: 8662660555
FaxNumber: 8662664999
Practice Location
Address1: 133 HARMONY PARK CIR
Address2:  
City: HOT SPRINGS
State: AR
PostalCode: 719135417
CountryCode: US
TelephoneNumber: 5016247700
FaxNumber: 5016235788
Other Information
ProviderEnumerationDate: 08/03/2012
LastUpdateDate: 05/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XE-10851ARN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RX0202XE-10851ARY Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology

No ID Information.


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