Basic Information
| Provider Information | |||||||||
| NPI: | 1912493107 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KARRI | ||||||||
| FirstName: | TULASI DEEPTHI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5303 S CEDAR ST STE 205 | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489113800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5178874305 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 760 W FRANKLIN ST | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492012048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5172052700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2018 | ||||||||
| LastUpdateDate: | 12/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0203X | 4301504070 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine | 208000000X | 4301504070 | MI | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 4301115516 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.