Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 27311 | AL |
NPI | 1013919760 |
---|---|
Provider Name | Dr. Rupa Kothandapani Kitchens |
First Address | Homewood, AL 35209-5603 |
Second Address | Homewood, AL 35209-5603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 24/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000057610 | MEDICARE PTAN (01) | AL |
009940369 | (05) | AL |
0366100001 | CIGNA GOVERNMENT SVC (01) | AL |
0366100001 | MC NSC (01) | |
I03706 | (02) | AL |