Provider Demographics
NPI:1235371303
Name:GONUGUNTA, NEELIMA K (MD,)
Entity type:Individual
Prefix:
First Name:NEELIMA
Middle Name:K
Last Name:GONUGUNTA
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:NEELIMA
Other - Middle Name:K
Other - Last Name:INTURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1710 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7303
Mailing Address - Country:US
Mailing Address - Phone:870-262-1200
Mailing Address - Fax:
Practice Address - Street 1:3443 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-8820
Practice Address - Country:US
Practice Address - Phone:870-262-1510
Practice Address - Fax:870-262-1516
Is Sole Proprietor?:No
Enumeration Date:2009-04-03
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-17638207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine