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1114003415

NPI Code Detail

MEDICARE: DR. ALAN J. ANTHONY MD

MEDICARE: DR. ALAN J. ANTHONY 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	207N00000X	Dermatology Physician	15007	NV
2	207N00000X	Dermatology Physician	01054521A	IN
3	207Q00000X	Family Medicine Physician	15007	NV
4	207Q00000X	Family Medicine Physician	01054521A	IN
5	207Q00000X	Family Medicine Physician	34242	SC
6	207N00000X	Dermatology Physician	34242	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P01578225	OTHER	IN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000970192	OTHER	IN	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114003415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN J. ANTHONY MD

Provider Business Mailing Address
First Line	:	3601 SW 160TH AVE STE 250
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-6314
Country	:	US
Telephone Number	:	954-399-4673
Fax Number	:

Provider Business Practice Location Address
First Line	:	331 E MAIN ST STE 200
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29730-5384
Country	:	US
Telephone Number	:	954-399-4673
Fax Number	:

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

Provider Enumeration Date	:	10/29/2006
Last Update Date	:	01/10/2025

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Directions to “ DR. ALAN J. ANTHONY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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