Pradeep Kumar Vaitla, MD

Nephrology Physician · Jackson, MS

Individual Active NPI

NPI number 1255645446

Practice location

2500 North State Street
Jackson, MS 39216-4500
Phone
(601) 984-5065
Fax
(601) 984-2962

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NPI record

NPI
1255645446
Entity type
Individual (Type 1)
Enumeration date
July 30, 2010
Last updated
July 2, 2019
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nephrology Physician Primary 207RN0300X 24433 MS
Nephrology Physician 207RN0300X MD.206335 LA

About Dr. Vaitla

Pradeep Kumar Vaitla, MD is a healthcare provider registered in the NPI registry with the primary taxonomy Nephrology Physician (code 207RN0300X). The practice location is 2500 North State Street, Jackson, MS 39216-4500. The NPI number 1255645446 was assigned on July 30, 2010 and the record was last updated on July 2, 2019.

Dr. Vaitla lists 2 licenses in the registry: #24433 (MS) for Nephrology Physician; #MD.206335 (LA) for Nephrology Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Pradeep Kumar Vaitla, MD?

The NPI number is 1255645446.

What is the phone number of Dr. Vaitla?

The phone number listed for the practice location is (601) 984-5065.

Where is Dr. Vaitla located?

2500 North State Street, Jackson, MS 39216-4500.

What is the taxonomy code for Dr. Vaitla?

The primary taxonomy code is 207RN0300X – Nephrology Physician; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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