Provider Demographics
NPI:1366424905
Name:ROY, ANAND KRISHNALAL (MD)
Entity type:Individual
Prefix:DR
First Name:ANAND
Middle Name:KRISHNALAL
Last Name:ROY
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 1:760 EAST BAYOU PINES
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-7184
Mailing Address - Country:US
Mailing Address - Phone:337-433-0313
Mailing Address - Fax:337-433-0554
Practice Address - Street 1:760 EAST BAYOU PINES
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-7184
Practice Address - Country:US
Practice Address - Phone:337-433-0313
Practice Address - Fax:337-433-0554
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10341 R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA49589780107OtherME
LA1989614Medicaid
LA10341ROtherSTATE LICENSE
LA49589780107OtherME
LA5U402Medicare ID - Type Unspecified