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NPI Code Detail

MEDICARE: DR. PRASHANTH ANAND M.D

MEDICARE: DR. PRASHANTH ANAND M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XX0004XOrthopaedic Foot and Ankle Surgery PhysicianRTL165439NC
2207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianP2622MD
3207X00000XOrthopaedic Surgery Physician036-131245IL

General Provider Information

NPI Number : 1578877619
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRASHANTH ANAND M.D
Provider Business Mailing Address
First Line : 800 E LOCUST ST
Second Line :
City : OLNEY
State : IL
Zip : 62450-2553
Country : US
Telephone Number : 618-395-7340
Fax Number :
Provider Business Practice Location Address
First Line : 1200 N EAST ST
Second Line : APT A
City : OLNEY
State : IL
Zip : 62450-2432
Country : US
Telephone Number : 618-395-6081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2010
Last Update Date : 10/12/2012

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