Individual
DR. ANESH PREMRAJH RUGNATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5900
(601) 984-5959
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
21692
MS
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
21692
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06929835
—
MS
05
—
185452
—
AL
01
—
302I220880
MEDICARE PTAN
MS
Enumeration date
12/16/2011
Last updated
05/24/2016
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