Healthcare Provider Details

I. General information

NPI: 1801818422
Provider Name (Legal Business Name): ANAND PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 HIGHWAY 192 E
LONDON KY
40741-3123
US

IV. Provider business mailing address

1380 HIGHWAY 192 E
LONDON KY
40741-3123
US

V. Phone/Fax

Practice location:
  • Phone: 606-862-0605
  • Fax: 606-862-6766
Mailing address:
  • Phone: 606-862-0605
  • Fax: 606-862-6766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number31680
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number37920
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number38197
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number39423
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3791P
License Number StateKY

VIII. Authorized Official

Name: ASHWINI ANAND
Title or Position: CEO
Credential: MD
Phone: 606-862-0605