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General NPI Number Information
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NPI Number | 1982051454
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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 | 05/16/2016
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 1202 S JAMES CAMPBELL BLVD STE 18
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City | COLUMBIA
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State | TN
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Zip | 38401-5162
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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 | 127 CREEKSIDE DR
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City | COLUMBIA
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State | TN
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Zip | 38401-6527
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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 | CHAIRMAN
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Name | MR. CHANDLER RAY 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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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