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Lavanya Boddu, MD
Family Medicine Physician in Mattoon, Illinois
NPI 1851503833

Lavanya Boddu is a Family Medicine Physician based in Urbana, IL. Lavanya Boddu practices in Mattoon, IL and has the professional credentials of MD. The NPI Number for Lavanya Boddu is 1851503833 and holds a License No. 036-121313 (Illinois).

The current practice location address for Lavanya Boddu is 2512 Hurst Dr Ste 120, Mattoon, IL and can be reached out via phone at 217-258-7590 and via fax at 217-258-3686.

Location: 2512 Hurst Dr Ste 120, Mattoon, IL, 61801
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1851503833
Provider Name
Lavanya Boddu
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
2512 Hurst Dr Ste 120, Mattoon, IL, 61801
Phone Number
217-258-7590
Fax Number
217-258-3686
Provider Enumeration Date
05/04/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
036121313 01 IL BLUE SHIELD
036121313-1 05 IL
institution
Provider Business Practice Location Address Details
Address
2512 Hurst Dr Ste 120
City
Mattoon
State
Illinois
Zip
61938-9200
Phone Number
217-258-7590
Fax Number
217-258-3686
person
Provider Business Mailing Address Details
Address
2512 Hurst Dr Ste 120
City
Mattoon
State
Illinois
Zip
61938-9200
Phone Number
217-258-7590
Fax Number
217-258-3686
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Emergency Medicine
Speciality
-
Taxonomy
207P00000X
License No.
036121313 (Illinois)
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
036-121313 (Illinois)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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