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Individual

DR. TEJASWI BHARI THIPPESWAMY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD,

Contact information

Practice address
1400 W 4TH, COFFEYVILLE, KS 67337-3306
(209) 383-7441
Mailing address
1910 CUSTOMER CARE WAY, ATWATER, CA 95301-5167
(209) 384-6488
(855) 202-9336

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0442440
KS
207Q00000X
Family Medicine Physician
25886
OK
207Q00000X
Family Medicine Physician
A132344
CA
207Q00000X
Family Medicine Physician
E6737
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
189923001
AR
01
5H894
BCBS
AR
01
9186194726
UNIVERSITY OF OKLAHOMA
OK
01
E6737
STATE LICENSE
AR
Enumeration date
08/09/2007
Last updated
01/23/2020
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