Provider Demographics
NPI:1578599635
Name:THIRUPPATHI, PRAKASH J (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAKASH
Middle Name:J
Last Name:THIRUPPATHI
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 1:2323 WHITTLESEY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-3011
Mailing Address - Country:US
Mailing Address - Phone:706-653-6344
Mailing Address - Fax:706-653-8933
Practice Address - Street 1:2323 WHITTLESEY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3011
Practice Address - Country:US
Practice Address - Phone:706-653-6344
Practice Address - Fax:706-653-8933
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047371174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA16BBDTBCMedicare ID - Type Unspecified
GAG70010Medicare UPIN