Provider Demographics
NPI:1598942328
Name:KURAKULA, PREETHI C (MD)
Entity Type:Individual
Prefix:
First Name:PREETHI
Middle Name:C
Last Name:KURAKULA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 S CLIFTON AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-2958
Mailing Address - Country:US
Mailing Address - Phone:316-274-8188
Mailing Address - Fax:
Practice Address - Street 1:1515 S CLIFTON AVE STE 205
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2958
Practice Address - Country:US
Practice Address - Phone:316-274-8188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49058 020390200000X
KS0435298207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program