Provider Demographics
NPI:1134384548
Name:NEEKHRA, ANEESH (MD)
Entity type:Individual
Prefix:
First Name:ANEESH
Middle Name:
Last Name:NEEKHRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 S GEAR AVE
Mailing Address - Street 2:SUITE 153, MERCY PLAZA
Mailing Address - City:WEST BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52655-1691
Mailing Address - Country:US
Mailing Address - Phone:319-754-4400
Mailing Address - Fax:319-754-4412
Practice Address - Street 1:1225 S GEAR AVE
Practice Address - Street 2:SUITE 153, MERCY PLAZA
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1686
Practice Address - Country:US
Practice Address - Phone:319-754-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI51949207W00000X
IA40351207W00000X, 2084N0400X
IL036.131026207W00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI54810006Medicare UPIN