Healthcare Provider Details
I. General information
NPI: 1285802892
Provider Name (Legal Business Name): RAVALI TARIGOPULA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/16/2008
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date: 01/21/2019
Reactivation Date: 01/23/2019
III. Provider practice location address
307 HOSPITAL RD
STARKVILLE MS
39759-2155
US
IV. Provider business mailing address
350 N HUMPHREYS BLVD
MEMPHIS TN
38120-2177
US
V. Phone/Fax
- Phone: 662-615-3043
- Fax: 662-615-3725
- Phone: 901-226-4003
- Fax: 901-227-8591
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | 310381 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 310381 |
| License Number State | LA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | 30516 |
| License Number State | MS |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 310381 |
| License Number State | LA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD.34174 |
| License Number State | AL |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | 310381 |
| License Number State | LA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | MD.34174 |
| License Number State | AL |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | MD.34174 |
| License Number State | AL |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | MD.34174 |
| License Number State | AL |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | ME153560 |
| License Number State | FL |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 310381 |
| License Number State | LA |
| # 12 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 30516 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
