Provider Demographics
NPI:1275598625
Name:NARRA, BAPUJI (MD)
Entity Type:Individual
Prefix:DR
First Name:BAPUJI
Middle Name:
Last Name:NARRA
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 1:411 CENTRAL AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SOUTH WILLIAMSON
Mailing Address - State:KY
Mailing Address - Zip Code:41503-4149
Mailing Address - Country:US
Mailing Address - Phone:606-237-6300
Mailing Address - Fax:606-237-7444
Practice Address - Street 1:411 CENTRAL AVE STE 1
Practice Address - Street 2:
Practice Address - City:SOUTH WILLIAMSON
Practice Address - State:KY
Practice Address - Zip Code:41503-4149
Practice Address - Country:US
Practice Address - Phone:606-237-6300
Practice Address - Fax:606-237-7444
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY216562085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0123244000Medicaid
KY64216567Medicaid
KY8577Medicare PIN
KYB42620Medicare UPIN
KY1719101Medicare ID - Type Unspecified
KY5490Medicare PIN
KY9371701Medicare PIN