Provider Demographics
NPI:1477537660
Name:MCPHERSON, ANTHONY ALPHONSO (MD)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:ALPHONSO
Last Name:MCPHERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 WOODMONT LN NW # 240
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2866
Mailing Address - Country:US
Mailing Address - Phone:910-227-9214
Mailing Address - Fax:
Practice Address - Street 1:2550 WINDY HILL RD SE STE 208209
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8665
Practice Address - Country:US
Practice Address - Phone:855-593-3479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC82138207L00000X
FLME128542208VP0014X
GA83519208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSCF336OtherMEDICARE
GAG18208COtherMEDICARE
GA003231887DMedicaid
FL019701200Medicaid
SC821383Medicaid
FLIRO56ZOtherMEDICARE