=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114998986
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANILKUMAR RAGHUNATH JOSHI MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2006
-----------------------------------------------------
Last Update Date | 06/28/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 295 WHARTON LANE
-----------------------------------------------------
City | NORTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24273
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-679-0321
-----------------------------------------------------
Fax | 276-679-6498
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2050 MEADOWVIEW PARKWAY SUITE 201
-----------------------------------------------------
City | KINGSPORT
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37660-7332
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-230-5000
-----------------------------------------------------
Fax | 423-230-5097
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 0101034579
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------