MEDICARE: DR. KARTHIKAYINI KATHIRAVAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	113358	GA

General Provider Information

NPI Number	:	1902738487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARTHIKAYINI KATHIRAVAN

Provider Business Mailing Address
First Line	:	631 WHISPERING PINES DR
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31211-6125
Country	:	US
Telephone Number	:	478-633-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 HEMLOCK ST
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31201-2102
Country	:	US
Telephone Number	:	478-633-7685
Fax Number	:	478-633-5127

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ DR. KARTHIKAYINI KATHIRAVAN ” Practice Location

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