Provider Demographics
NPI:1841273968
Name:CHILUKURI, KRISHNA R (MD)
Entity type:Individual
Prefix:
First Name:KRISHNA
Middle Name:R
Last Name:CHILUKURI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4166 WYNTREE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-2521
Mailing Address - Country:US
Mailing Address - Phone:812-858-5050
Mailing Address - Fax:812-858-3680
Practice Address - Street 1:4166 WYNTREE DR
Practice Address - Street 2:SUITE A
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-2521
Practice Address - Country:US
Practice Address - Phone:812-858-5050
Practice Address - Fax:812-858-3680
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2025-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01036898A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INE41937Medicare UPIN
IN139690BMedicare ID - Type Unspecified