Basic Information
| Provider Information | |||||||||
| NPI: | 1245223411 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NADAR | ||||||||
| FirstName: | ANBU | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 419 TOWN MOUNTAIN RD | ||||||||
| Address2: | SUITE 107 | ||||||||
| City: | PIKEVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 415011631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064320016 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 911 BYPASS RD BLDG A | ||||||||
| Address2: | |||||||||
| City: | PIKEVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 415011689 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064302206 | ||||||||
| FaxNumber: | 6062187506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2005 | ||||||||
| LastUpdateDate: | 06/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 23240 | KY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 174400000X | 23240 | KY | N | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 64232408 | 05 | KY | MEDICAID |