JAGADEESHWAR GUNDAJI NPI 1316158868

NPI Information

NPI: 1316158868
Provider Name: JAGADEESHWAR GUNDAJI
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Address:
1501 KINGS HWY
DEPARTMENT OF FAMILY MEDICINE
SHREVEPORT, LA
ZIP 71103
Phone: (318) 675-5000
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Jagadeeshwar Gundaji is a student in an organized health care education training program in Shreveport, LA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Jagadeeshwar Gundaji NPI is 1316158868. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1501 KINGS HWY
DEPARTMENT OF FAMILY MEDICINE
SHREVEPORT, LA
ZIP 71103-228
Phone: (318) 675-5000

The enumeration date for this NPI number is 5/25/2007 and was last updated on 5/30/2008.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00019	MEDICAID	LOUISIANA

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

NPI Synchronization or Removal

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