MEDICARE: KEERTHI GULLAPALLI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	47511	OK

General Provider Information

NPI Number	:	1689290801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEERTHI GULLAPALLI MD

Provider Business Mailing Address
First Line	:	1245 S UTICA AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74104-4214
Country	:	US
Telephone Number	:
Fax Number	:	918-579-3850

Provider Business Practice Location Address
First Line	:	1245 S UTICA AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74104-4214
Country	:	US
Telephone Number	:	918-579-3850
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2020
Last Update Date	:	04/26/2026

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