Basic Information
Provider Information
NPI: 1033406731
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YARRA
FirstName: PRADEEP
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: UK DIVISION OF HOSPITAL MEDICINE
Address2: 800 ROSE STREET, MN604
City: LEXINGTON,
State: KY
PostalCode: 40536
CountryCode: US
TelephoneNumber: 8593236047
FaxNumber: 8592573873
Practice Location
Address1: UK DIVISION OF HOSPITAL MEDICINE 800 ROSE SR
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360001
CountryCode: US
TelephoneNumber: 8593236047
FaxNumber: 8592573873
Other Information
ProviderEnumerationDate: 07/01/2011
LastUpdateDate: 07/06/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X50520KYN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X50520KYY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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