Provider Demographics
NPI:1689763856
Name:ANAND, VINOD KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:VINOD
Middle Name:KUMAR
Last Name:ANAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:501 MARSHALL STREET PO BOX 1000
Mailing Address - Street 2:SUITE # 602
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202
Mailing Address - Country:US
Mailing Address - Phone:601-969-1910
Mailing Address - Fax:601-969-1913
Practice Address - Street 1:501 MARSHALL STREET
Practice Address - Street 2:SUITE # 602
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202
Practice Address - Country:US
Practice Address - Phone:601-969-1910
Practice Address - Fax:601-969-1913
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS09754207Y00000X, 207YP0228X, 207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00012430Medicaid
MS00012430Medicaid
MS040000166Medicare ID - Type Unspecified