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General NPI Number Information
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NPI Number | 1649290404
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Entity Type | Individual
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Provider Name | VIJAY A RUPANAGUDI MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 135 W 3RD ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-2478
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Country | US
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Telephone | 931-202-3697
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Fax | 833-944-0207
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Provider Business Mailing Address
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Address Line | 135 W 3RD ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-2478
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Country | US
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Telephone | 931-202-3694
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Fax | 833-944-0207
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 45978
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MD45978
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License Number State | TN
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