MEDICARE: DR. ANIL KRISHNA BACHU 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
1	2084P0800X	Psychiatry Physician	MD461275	PA
2	2084P0800X	Psychiatry Physician	78012	MN
3	2084P0800X	Psychiatry Physician	E-12545	AR
4	2084P0800X	Psychiatry Physician	2024-01539	NC
5	2084P0800X	Psychiatry Physician	35127873	OH
6	2084P0800X	Psychiatry Physician	V3747	TX

General Provider Information

NPI Number	:	1689017550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANIL KRISHNA BACHU M.D.

Provider Business Mailing Address
First Line	:	3401 SPRINGHILL DR STE 240
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2926
Country	:	US
Telephone Number	:	501-945-8838
Fax Number	:	501-945-8835

Provider Business Practice Location Address
First Line	:	3401 SPRINGHILL DR STE 240
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2926
Country	:	US
Telephone Number	:	501-945-8838
Fax Number	:	501-945-8835

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2013
Last Update Date	:	03/25/2026

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