Healthcare Provider Details

I. General information

NPI: 1295732063
Provider Name (Legal Business Name): STEVEN R ANDERSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7268 JARNIGAN RD SUITE 200
CHATTANOOGA TN
37421-3096
US

IV. Provider business mailing address

PO BOX 6188
CHATTANOOGA TN
37401-6188
US

V. Phone/Fax

Practice location:
  • Phone: 423-508-7337
  • Fax: 423-508-7338
Mailing address:
  • Phone: 423-508-7337
  • Fax: 423-508-7338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD14966
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD-14966
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: