Basic Information
Provider Information
NPI: 1124049408
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KIRK
FirstName: TRIPURANENI
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 143 W FRANKLIN ST
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275162539
CountryCode: US
TelephoneNumber: 9199664131
FaxNumber:  
Practice Location
Address1: 101 MANNING DR
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275990001
CountryCode: US
TelephoneNumber: 9199664131
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/21/2006
LastUpdateDate: 12/14/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101X0101239707VAN Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
207RE0101X2008-00933NCY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

No ID Information.


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