Individual
DR. RAJESH KURUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1500 E WOODROW WILSON AVE., JACKSON, MS 39216-5199
(601) 362-4471
(601) 364-1357
Mailing address
500 AVALON WAY, APT 1513, BRANDON, MS 39047-7533
(248) 767-2363
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20437
MS
208600000X
Surgery Physician
4301076797
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06872096
—
MS
Enumeration date
04/03/2007
Last updated
06/06/2012
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