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General NPI Number Information
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NPI Number | 1821328451
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Entity Type | Organization
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Legal Business Name | KENNETH E. ANDERSON JR. M.D. P.A.
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Dates
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Enumeration Date | 01/04/2010
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 500 E PEYTON ST
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City | SHERMAN
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State | TX
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Zip | 75090-0200
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Country | US
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Telephone | 903-893-6000
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Fax | 903-868-1802
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Provider Business Mailing Address
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Address Line | 500 E PEYTON ST
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City | SHERMAN
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State | TX
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Zip | 75090-0200
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Country | US
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Telephone | 903-893-6000
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Fax | 903-868-1802
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH E ANDERSON JR.
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Credential | M.D.
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Telephone | 903-893-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | L6764
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License Number State | TX
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