DR. VENKATA SURYA PHANI BHUSHAN DURVASULA (NPI# 1770861478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770861478 |
| Entity Type | Individual |
| Full Name | DR. VENKATA SURYA PHANI BHUSHAN DURVASULA |
| Credential | M.D. |
| Practice Address |
4301 W Markham St # 543 Department of Otolaryngology Little Rock AR 72205-7101 |
| Practice Telephone | 5016865140 |
| Practice Fax Number | 5016865878 |
| Mailing Telephone | 5016865140 |
| Mailing Fax Number | 5016865878 |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2014-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | E-7645 | AR | Allopathic & Osteopathic Physicians |
| Street Address |
4301 W MARKHAM ST # 543 DEPARTMENT OF OTOLARYNGOLOGY |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-7101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689730459 | Gordon Carl Shipp | Otolaryngology | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2006-12-28 |
| 1700414521 | Aryan Shay | Student in an Organized Health Care Education/Training Program | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2020-03-28 |
| 1245868124 | Anna Celeste Gibson | Student in an Organized Health Care Education/Training Program | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2020-03-27 |
| 1043848906 | Chrystal Lau | Student in an Organized Health Care Education/Training Program | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2020-03-27 |
| 1821559840 | Sriram Navuluri | Student in an Organized Health Care Education/Training Program | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2019-03-31 |
| 1467913707 | Anvesh Reddy Kompelli | Student in an Organized Health Care Education/Training Program | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2019-03-28 |
| 1861953119 | Mary Catherine Brown | Student in an Organized Health Care Education/Training Program | 4301 W Markham St # 543, Little Rock, AR 72205-7199 | 2019-03-28 |
| 1871099499 | Blake R Hollowoa | Student in an Organized Health Care Education/Training Program | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2018-04-03 |
| 1821594409 | Erin Rachel Creighton | Student in an Organized Health Care Education/Training Program | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2018-04-03 |
| 1528564556 | Tyler Branch Merrill | Student in an Organized Health Care Education/Training Program | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2018-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
| 1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
| 1225667272 | Ann-marie Frances Hayre | Student in an Organized Health Care Education/Training Program | 4310 West Markham, Slot 589, Little Rock, AR 72205 | 2020-04-02 |
| 1952930075 | Alexandria Leigh Smith | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot 531, Little Rock, AR 72205 | 2020-04-02 |
| 1093353922 | Phil Fagala | Pharmacist | 614 North Beechwood, Little Rock, AR 72205 | 2019-12-10 |
| 1295391688 | Home To Community Living, Inc | Physical Therapist | 10201 W Markham Street Pulaski, Little Rock, AR 72205 | 2019-05-12 |
| 1669933693 | Sandy Louise Webb | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 530, Little Rock, AR 72205 | 2019-03-31 |
| 1457812828 | Vincent Battafarano | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 602, Little Rock, AR 72205 | 2019-03-28 |
| 1063978922 | Franks Pediatric Occupational Therapy LLC | Occupational Therapist | 5516 C St, Little Rock, AR 72205 | 2019-02-15 |
| 1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
| Find all providers in zip 72205 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437590080 | John R Sims | Otolaryngology | 8901 Carti Way Ste 201, Little Rock, AR 72205-6523 | 2013-07-11 |
| 1558650960 | Graham Michael Strub | Otolaryngology | 1 Childrens Way # 836, Little Rock, AR 72202-3500 | 2011-04-06 |
| 1689730459 | Gordon Carl Shipp | Otolaryngology | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2006-12-28 |
| 1669452686 | Jeffrey L Barber | Otolaryngology | 10201 Kanis Rd, Little Rock, AR 72205-6203 | 2006-01-17 |
| 1427543651 | Joshua Jervis-bardy | Otolaryngology | 4301 W Markham St, Little Rock, AR 72205-7101 | 2018-06-29 |
| 1104293687 | Aaron Damian Trinidade | Otolaryngology | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2015-08-31 |
| 1477932861 | Charles Lane Anzalone Jr. | Otolaryngology | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2015-05-19 |
| 1528454881 | Quinn Dunlap | Otolaryngology | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2015-04-13 |
| 1801282231 | James Shepherd Russell Iv | Otolaryngology | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2015-04-13 |
| 1467884668 | Alissa Kanaan | Otolaryngology | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2013-07-30 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72205 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.