Individual
VIJAY A RUPANAGUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
135 W 3RD ST, COOKEVILLE, TN 38501-2478
(931) 202-3697
(833) 944-0207
Mailing address
135 W 3RD ST, COOKEVILLE, TN 38501-2478
(931) 202-3694
(833) 944-0207
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
45978
TN
207RP1001X
Pulmonary Disease Physician
Primary
MD45978
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1520062
—
TN
01
—
4267428
BCBS
TN
05
—
7100187270
—
KY
05
—
Q059015
—
TN
Enumeration date
07/21/2006
Last updated
01/25/2021
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