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General NPI Number Information
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NPI Number | 1376772541
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Entity Type | Individual
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Provider Name | KIRAN KOUSHIK NAGARAJAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 10/12/2024
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Provider Practice Location Address
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Address Line | JOHNSON BUILDING SUITE 227A 847 MONROE AVENUE
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City | MEMPHIS
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State | TN
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Zip | 38163-2140
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Country | US
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Telephone | 901-448-6661
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Fax |
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Provider Business Mailing Address
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Address Line | 3522 GOLDEN VALLEY LN
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City | BARTLETT
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State | TN
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Zip | 38133-5805
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Country | US
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Telephone | 919-961-0382
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 71185
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 61267
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2020-04699
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 71185
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License Number State | TN
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