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NPI Code Detail

MEDICARE: DR. KEISA G. ANDERSON M.D.

MEDICARE: DR. KEISA G. ANDERSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician59159GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629286745
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEISA G. ANDERSON M.D.
Provider Business Mailing Address
First Line : 860 JOHNSON FERRY RD STE 140377
Second Line :
City : ATLANTA
State : GA
Zip : 30342-1435
Country : US
Telephone Number : 470-750-7573
Fax Number : 470-750-7573
Provider Business Practice Location Address
First Line : 4300 PACES FERRY RD SE STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5714
Country : US
Telephone Number : 470-750-7573
Fax Number : 470-750-6722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 02/26/2026

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Directions to “ DR. KEISA G. ANDERSON M.D.” Practice Location

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