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Individual

ANAND PREM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
2500 N STATE ST, UNIVERSITY OF MISSISSIPPI MEDICAL CTR, ANESTHESIOLOGY,, JACKSON, MS 39216-4500
(601) 984-5900
(601) 984-5939
Mailing address
2500 NORTH STATE ST, JACKSON, MS 39216
(601) 984-5900
(601) 984-5939

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
20466
MS
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
20466
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04000391
MS
05
106564
AL
05
1921980
LA
01
512I050098
MEDICARE PTAN
MS
Enumeration date
07/21/2006
Last updated
06/15/2012
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