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General NPI Number Information
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NPI Number | 1518347806
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Entity Type | Organization
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Legal Business Name | ANDERSON MEDICAL
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 07/19/2017
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Provider Practice Location Address
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Address Line | 1202 S JAMES CAMPBELL BLVD SUITE 18
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City | COLUMBIA
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State | TN
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Zip | 38401-5193
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Country | US
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Telephone | 931-446-7865
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Fax | 931-901-0771
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Provider Business Mailing Address
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Address Line | 1202 S JAMES CAMPBELL BLVD SUITE 18
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City | COLUMBIA
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State | TN
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Zip | 38401-5193
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Country | US
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Telephone | 931-446-7865
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Fax | 931-901-0771
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHANDLER R ANDERSON
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Credential | FNP
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Telephone | 931-446-7865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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