MEDICARE: JOHN M 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
1	2085R0001X	Radiation Oncology Physician	MD35666	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	920006665	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053384362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN M ANDERSON MD

Provider Business Mailing Address
First Line	:	DEPT 888025
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37995-8025
Country	:	US
Telephone Number	:	512-583-0205
Fax Number	:	512-583-2001

Provider Business Practice Location Address
First Line	:	908 WEST 4TH NORTH STREET
Second Line	:	DEPT OF RADIATION ONCOLOGY
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-3894
Country	:	US
Telephone Number	:	423-522-5000
Fax Number	:	423-522-4901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	12/14/2009

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