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DR. JYOTHI DYAVANAPALLI GUDLA M.D NPI 1194872713


NPI Information

NPI: 1194872713
Provider Name: DR. JYOTHI DYAVANAPALLI GUDLA, M.D
Classification: Internal Medicine - 207RG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

PECOS Registration: Yes

Address:
4808 MUNSON ST NW
CANTON, OH
ZIP 44718
Phone: (330) 622-0207
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DR. Jyothi Dyavanapalli Gudla, M.D is a geriatric medicine internal medicine in Canton, OH with 28 years of experience. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. DR. Jyothi Dyavanapalli Gudla, M.D NPI is 1194872713. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4808 MUNSON ST NW
CANTON, OH
ZIP 44718-613
Phone: (330) 622-0207
Fax: (330) 832-3499

The NPI 1194872713 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/4/2007 and was last updated on 8/24/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine35-083145OHIONo
2207R00000XInternal Medicine35.083145OHIONo
3208M00000XHospitalist35-083145OHIONo
4207RG0300XInternal MedicineGeriatric Medicine35.083145OHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.