Healthcare Provider Details

I. General information

NPI: 1467459412
Provider Name (Legal Business Name): ANAND C THAKUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 US HIGHWAY 27 N STE 100
SEBRING FL
33870-1323
US

IV. Provider business mailing address

5115 US HIGHWAY 27 N STE 100
SEBRING FL
33870-1323
US

V. Phone/Fax

Practice location:
  • Phone: 863-385-2222
  • Fax: 863-382-8765
Mailing address:
  • Phone: 863-385-2222
  • Fax: 863-382-8765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number4301093287
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME150875
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: