Ramesh Reddy Keesara, MD
Individual provider Active NPI Internal Medicine Physician · Decaturville, TN
NPI 1649223447 · NPPES record last updated Mar 20, 2013
Key facts
- NPI
- 1649223447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 12891 (TN)
- Practice address
- 187 W Main St
Decaturville, TN 38329 - Phone
- (731) 852-2761
- Fax
- (731) 852-2781
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12891 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chelsey Sparks Dba Decaturville Family Practice | Current |
Accepting new patients |
Locations
187 W Main St
Decaturville, TN 38329
Phone (731) 852-2761
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 12891 | TN | Yes |
Addresses
Primary practice location
187 W Main St
Decaturville, TN 38329
Mailing address
187 W Main St
PO Box 127
Decaturville, TN 38329
Phone (731) 852-2761
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3183218 | Medicaid | TN | |
| 0001364 | Other | TN | BCBS OF TN PIN |
Other providers in Decaturville, TN
- Sheila W Hensley
- Melissa Isbell
- Melissa Jones
- K. Ramesh Reddy
- Teri Jolanda Kapp
- Paige Clayton Keeton
- Elaine Kirk
- Crystal Kuykendall
- Tony Litle
- Stephanie Banks McCready
All providers in Decaturville, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.