Provider Demographics
NPI:1033524863
Name:KORRAPATI, CHAITANYA (MD)
Entity Type:Individual
Prefix:
First Name:CHAITANYA
Middle Name:
Last Name:KORRAPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MELROSE CV
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2775
Mailing Address - Country:US
Mailing Address - Phone:423-930-5278
Mailing Address - Fax:
Practice Address - Street 1:1808 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-2724
Practice Address - Country:US
Practice Address - Phone:479-964-4178
Practice Address - Fax:479-964-5910
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-12012208M00000X
MDD86707207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist