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General NPI Number Information
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NPI Number | 1043764699
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Entity Type | Organization
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Legal Business Name | ANDERSON REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 2124 14TH ST
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City | MERIDIAN
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State | MS
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Zip | 39301-4040
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Country | US
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Telephone | 601-553-6000
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Fax | 601-703-0124
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Provider Business Mailing Address
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Address Line | 2124 14TH ST
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City | MERIDIAN
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State | MS
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Zip | 39301-4040
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Country | US
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Telephone | 601-703-3480
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Fax | 601-703-0124
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Authorized Official
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Title or Position | SR VP / CLO
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Name | GREGORY M DUCKETT
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Credential |
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Telephone | 901-227-5233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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