Healthcare Provider Details

I. General information

NPI: 1285849927
Provider Name (Legal Business Name): RAGHUVEER KURA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2651 SHELBY RD
POPLAR BLUFF MO
63901-2387
US

IV. Provider business mailing address

2651 SHELBY RD
POPLAR BLUFF MO
63901-2387
US

V. Phone/Fax

Practice location:
  • Phone: 573-843-8380
  • Fax: 573-843-8381
Mailing address:
  • Phone: 573-843-8380
  • Fax: 573-843-8381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT181651
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number2010017360
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number062539
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: