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General NPI Number Information
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NPI Number | 1902821739
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Entity Type | Individual
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Provider Name | ANILKUMAR N VINAYAKAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 315 E BROADWAY STE 185-E
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City | LOUISVILLE
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State | KY
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Zip | 40202-3700
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Country | US
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Telephone | 502-629-5455
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Fax | 502-629-4151
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 38717
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 38717
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License Number State | KY
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