Provider Demographics
NPI:1912038472
Name:THIPPESWAMY T. CHANNAPATI, MD PC
Entity Type:Organization
Organization Name:THIPPESWAMY T. CHANNAPATI, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THIPPESWAMY
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHANNAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-282-8011
Mailing Address - Street 1:342 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4921
Mailing Address - Country:US
Mailing Address - Phone:724-282-8011
Mailing Address - Fax:724-282-3165
Practice Address - Street 1:342 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4921
Practice Address - Country:US
Practice Address - Phone:724-282-8011
Practice Address - Fax:724-282-3165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty