Provider Demographics
NPI:1831337070
Name:ANJANI D. NARRA MD LLC
Entity type:Organization
Organization Name:ANJANI D. NARRA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANJANI
Authorized Official - Middle Name:D
Authorized Official - Last Name:NARRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-752-4755
Mailing Address - Street 1:19431 N MUIRFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-5986
Mailing Address - Country:US
Mailing Address - Phone:225-752-4755
Mailing Address - Fax:225-753-2226
Practice Address - Street 1:4428 NORTH BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3917
Practice Address - Country:US
Practice Address - Phone:225-802-9898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAN05559R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB86994Medicare UPIN