Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 036-131245 | IL |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | RTL165439 | NC |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | P2622 | MD |
NPI | 1578877619 |
---|---|
Provider Name | Dr. Prashanth Anand |
First Address | Olney, IL 62450-2553 |
Second Address | Olney, IL 62450-2432 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2010 |
Last Update Date | 12/10/2012 |