Healthcare Provider Details

I. General information

NPI: 1972720175
Provider Name (Legal Business Name): ANDERSON REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 14TH ST
MERIDIAN MS
39301
US

IV. Provider business mailing address

2124 14TH ST
MERIDIAN MS
39301-4040
US

V. Phone/Fax

Practice location:
  • Phone: 601-703-3480
  • Fax: 601-703-0124
Mailing address:
  • Phone: 601-703-3480
  • Fax: 601-703-0124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN ANDERSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 601-553-6000