Basic Information
Provider Information
NPI: 1508228065
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TARPARA
FirstName: KISHAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
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Mailing Information
Address1: 3841 GREEN HILLS VILLAGE DR STE 200
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372152691
CountryCode: US
TelephoneNumber: 6153225000
FaxNumber:  
Practice Location
Address1: 3601 THE VANDERBILT CLINIC
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372327201
CountryCode: US
TelephoneNumber: 6153225000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/24/2016
LastUpdateDate: 10/13/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/13/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RS0012X4839TNY Allopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine

No ID Information.


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