Basic Information
Provider Information
NPI: 1003014705
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JINDAL
FirstName: ANKUR
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2705
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358042705
CountryCode: US
TelephoneNumber: 2562650780
FaxNumber: 2562650781
Practice Location
Address1: 201 SIVLEY RD SW
Address2: SUITE 440
City: HUNTSVILLE
State: AL
PostalCode: 358015134
CountryCode: US
TelephoneNumber: 2562650780
FaxNumber: 2562650781
Other Information
ProviderEnumerationDate: 07/05/2007
LastUpdateDate: 04/03/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X30427ALN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RE0101X30427ALY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

ID Information
IDTypeStateIssuerDescription
102I11235901ALMEDICAREOTHER
19039105AL MEDICAID


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