Healthcare Provider Details

I. General information

NPI: 1275322828
Provider Name (Legal Business Name): PRUTHVI SAI CHOWDARY ALURI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date: 02/17/2026
Reactivation Date: 03/04/2026

III. Provider practice location address

2500 N STATE ST
JACKSON MS
39216-4500
US

IV. Provider business mailing address

2500 N STATE ST
JACKSON MS
39216-4500
US

V. Phone/Fax

Practice location:
  • Phone: 601-984-6800
  • Fax:
Mailing address:
  • Phone: 601-984-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberT-5910
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: