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1811189269 NPI number — TEJASWI BHARI THIPPESWAMY MD,

NPI Number: 1811189269
Health Care Provider/Practitioner: TEJASWI BHARI THIPPESWAMY MD,

Information about “1811189269” NPI (TEJASWI BHARI THIPPESWAMY MD,) exists in 1811189269 in HTML format HTML  |  1811189269 in plain Text format TXT  |  1811189269 in PDF (Portable Document Format) PDF  |  1811189269 in an XML format XML  formats.

NPI Number : 1811189269 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1811189269",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "THIPPESWAMY",
    "FirstName": "TEJASWI",
    "MiddleName": "BHARI",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD,",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1910 CUSTOMER CARE WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ATWATER",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95301-5167",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "209-384-6488",
    "MailingAddressFaxNumber": "855-202-9336",
    "FirstLinePracticeLocationAddress": "1400 W 4TH",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COFFEYVILLE",
    "PracticeLocationAddressStateName": "KS",
    "PracticeLocationAddressPostalCode": "67337-3306",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "209-383-7441",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/09/2007",
    "LastUpdateDate": "01/23/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "25886",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "E6737",
          "LicenseNumberStateCode": "AR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "A132344",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "0442440",
          "LicenseNumberStateCode": "KS",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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