Provider Demographics
NPI:1053388306
Name:PARGHI, ANJAN R (MD)
Entity type:Individual
Prefix:DR
First Name:ANJAN
Middle Name:R
Last Name:PARGHI
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 1:847 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4117
Mailing Address - Country:US
Mailing Address - Phone:904-264-4541
Mailing Address - Fax:904-278-2709
Practice Address - Street 1:847 PARK AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073
Practice Address - Country:US
Practice Address - Phone:904-264-4541
Practice Address - Fax:904-278-2709
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77579174400000X, 207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No174400000XOther Service ProvidersSpecialist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL46594AMedicare ID - Type Unspecified
FLH00524Medicare UPIN