Provider Demographics
NPI:1578538427
Name:CHIRRAVURI, VEERABHADRA R (MD)
Entity Type:Individual
Prefix:
First Name:VEERABHADRA
Middle Name:R
Last Name:CHIRRAVURI
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:PO BOX 1086
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42241-1086
Mailing Address - Country:US
Mailing Address - Phone:270-887-0700
Mailing Address - Fax:270-885-3776
Practice Address - Street 1:315 COOL WATER CT
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-8738
Practice Address - Country:US
Practice Address - Phone:270-887-0700
Practice Address - Fax:270-228-0567
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35171207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64994999Medicaid
G27220Medicare UPIN
KY64994999Medicaid