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General NPI Number Information
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NPI Number | 1124584800
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Entity Type | Individual
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Provider Name | TEESSA PEREKATTU KURUVILLA MD
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Gender | Female
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Dates
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Enumeration Date | 02/18/2019
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | DEPARTMENT OF RADIATION ONCOLOGY 350 WOODROW WILSON DR
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City | JACKSON
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State | MS
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Zip | 39216-4505
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Country | US
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Telephone | 601-815-6886
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Fax | 601-815-1846
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Provider Business Mailing Address
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Address Line | UNIVERSITY OF MS MEDICAL CENTER 2500 N STATE ST DEPARTMENT OF RADIATION ONCOLOGY
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City | JACKSON
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State | MS
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Zip | 39216-4505
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Country | US
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Telephone | 601-815-6886
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Fax | 601-815-1846
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | T-3726
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 01095903A
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License Number State | IN
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