Provider Demographics
NPI:1194854653
Name:ANAND CLINIC
Entity Type:Organization
Organization Name:ANAND CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-796-3245
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:621 WEST MAIN STREET
Mailing Address - City:HOHENWALD
Mailing Address - State:TN
Mailing Address - Zip Code:38462-0130
Mailing Address - Country:US
Mailing Address - Phone:931-796-3245
Mailing Address - Fax:931-796-2315
Practice Address - Street 1:621 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HOHENWALD
Practice Address - State:TN
Practice Address - Zip Code:38462-1355
Practice Address - Country:US
Practice Address - Phone:931-796-3245
Practice Address - Fax:931-796-2315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD8372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3051387Medicaid
TN3154624Medicaid
TN3728440Medicaid
TN3853236Medicaid
TN3051387Medicare ID - Type Unspecified
TN3853236Medicare ID - Type Unspecified
TNE39258Medicare UPIN
TN3728440Medicare ID - Type Unspecified
TN3728440Medicaid
TNE32937Medicare UPIN
TN3154624Medicaid