Provider Demographics
NPI:1518347806
Name:ANDERSON MEDICAL
Entity Type:Organization
Organization Name:ANDERSON MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHANDLER
Authorized Official - Middle Name:R
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:931-446-7865
Mailing Address - Street 1:1202 S JAMES CAMPBELL BLVD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-5193
Mailing Address - Country:US
Mailing Address - Phone:931-446-7865
Mailing Address - Fax:931-901-0771
Practice Address - Street 1:1202 S JAMES CAMPBELL BLVD
Practice Address - Street 2:SUITE 18
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-5193
Practice Address - Country:US
Practice Address - Phone:931-446-7865
Practice Address - Fax:931-901-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center