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Individual

PRAVIN N AVULA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
121 COLLEGE ST, SMITHS GROVE, KY 42171
(270) 563-3000
(270) 783-3753
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 563-3000
(270) 783-3753

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31173
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64311731
KY
Enumeration date
06/09/2006
Last updated
07/21/2022
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