Provider Demographics
NPI:1649398736
Name:FORD, ANNE L (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:L
Last Name:FORD
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 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1210 MEDICAL ARTS BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3461
Practice Address - Country:US
Practice Address - Phone:765-298-4660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43960207RC0000X
IN01065795A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200923350Medicaid
IN000000594817OtherANTHEM BCBS
IN000000623344OtherANTHEM BCBS
INP00738830OtherRAILROAD MEDICARE
INP00743618OtherRAILROAD MEDICARE
INP01455411OtherMEDICARE RAILROAD PTAN
INP01455411OtherMEDICARE RAILROAD PTAN
IN183380VVVVMedicare PIN
IN000000623344OtherANTHEM BCBS
IN000000594817OtherANTHEM BCBS