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NPI Code Detail

MEDICARE: DR. MARK D ANDERSON MD

MEDICARE:  DR. MARK D ANDERSON  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology PhysicianMD0000019697TN
2207RG0100XGastroenterology Physician036174985IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12005657OTHERTNBCBS OF TN

General Provider Information

NPI Number : 1003993163
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK D ANDERSON MD
Provider Business Mailing Address
First Line : PO BOX 888197
Second Line :
City : KNOXVILLE
State : TN
Zip : 37995-0001
Country : US
Telephone Number : 865-305-6570
Fax Number : 865-305-6576
Provider Business Practice Location Address
First Line : 1928 ALCOA HWY
Second Line : B100
City : KNOXVILLE
State : TN
Zip : 37920
Country : US
Telephone Number : 865-544-6570
Fax Number : 865-544-6576
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 02/04/2026

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