Healthcare Provider Details

I. General information

NPI: 1669673281
Provider Name (Legal Business Name): GAIL F ANDERSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 LENOX POINTE NE
ATLANTA GA
30324-3169
US

IV. Provider business mailing address

36 LENOX POINTE NE
ATLANTA GA
30324-3169
US

V. Phone/Fax

Practice location:
  • Phone: 404-237-3636
  • Fax:
Mailing address:
  • Phone: 404-237-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number22382
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: