Provider Demographics
NPI:1831439595
Name:GUNTURI, RATIKA (DO)
Entity type:Individual
Prefix:
First Name:RATIKA
Middle Name:
Last Name:GUNTURI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RATIKA
Other - Middle Name:
Other - Last Name:KAVURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1211 UNION AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5908 GETWELL RD
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-7317
Practice Address - Country:US
Practice Address - Phone:901-536-4646
Practice Address - Fax:662-536-4443
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA076321207Q00000X
MS32511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003181527EMedicaid
GA003181527CMedicaid