Individual provider · NPI-1

Dr. Srinivas Mahesh Katta, MD

Internal Medicine, Nephrology · Muskogee, OK

NPI number1841428752
StatusActive
Last updated in NPPESAug 25, 2023

Details

NPI
1841428752
Entity type
Individual (NPI-1)
Name
Dr. Srinivas Mahesh Katta
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jun 30, 2009
Certification date
Aug 25, 2023
Last updated
Aug 25, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RN0300X Internal Medicine, Nephrology30949OKYes
207R00000X Internal Medicine30949OK
207R00000X Internal MedicineMD61441562WA
207RN0300X Internal Medicine, Nephrology2012011844MO
208M00000X Hospitalist2020041626MO
208M00000X Hospitalist27938NE

Practice location

3501 W Broadway St
Muskogee, OK 74401-2138

Phone 918-913-9408 · Fax 888-383-0122

Mailing address

2505 Bacon Ct
Muskogee, OK 74403-1662

Phone 732-986-1758 · Fax 888-383-0122

Other practice locations

1202 W Cherokee St
Wagoner, OK 74467-4629

Phone 918-485-1205 · Fax 918-485-1695

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