Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | L9301 | TX |
N | 111NI0900X | Internist | L9301 | TX |
Y | 207RC0000X | Internist - Cardiovascular Disease | E12282 | AR |
N | 207RC0000X | Internist - Cardiovascular Disease | L9301 | TX |
N | 207U00000X | Nuclear Medicine Specialist | L9301 | TX |
NPI | 1568490118 |
---|---|
Provider Name | Dr. Kiran Ram Kurichety |
First Address | Rogers, AR 72758-1456 |
Second Address | Rogers, AR 72758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 23/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I16174 | (02) | TX |