Basic Information
| Provider Information | |||||||||
| NPI: | 1538424346 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ATLURI | ||||||||
| FirstName: | PAAVANI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 940 E 5TH ST | ||||||||
| Address2: | |||||||||
| City: | COQUILLE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974231666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413963101 | ||||||||
| FaxNumber: | 5413961783 | ||||||||
| Practice Location | |||||||||
| Address1: | 790 E 5TH ST | ||||||||
| Address2: | |||||||||
| City: | COQUILLE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413963101 | ||||||||
| FaxNumber: | 5413965891 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2012 | ||||||||
| LastUpdateDate: | 08/08/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD172464 | OR | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.