Provider Demographics
NPI:1265447700
Name:PILLAI, ANITHA (MD)
Entity Type:Individual
Prefix:
First Name:ANITHA
Middle Name:
Last Name:PILLAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 N RACE ST
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-3454
Mailing Address - Country:US
Mailing Address - Phone:270-659-3381
Mailing Address - Fax:270-659-3383
Practice Address - Street 1:1301 N RACE ST
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-3454
Practice Address - Country:US
Practice Address - Phone:270-651-4353
Practice Address - Fax:270-659-3383
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64244207R00000X, 208M00000X
VA0101245090207R00000X
KY44226207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI45004Medicare UPIN
VA023118I87Medicare PIN