Provider Demographics
NPI:1568488799
Name:ANDERSON CLINIC INC
Entity Type:Organization
Organization Name:ANDERSON CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPPELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-892-6500
Mailing Address - Street 1:2800 S SHIRLINGTON RD STE 1000
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3614
Mailing Address - Country:US
Mailing Address - Phone:703-892-6500
Mailing Address - Fax:703-892-1550
Practice Address - Street 1:2800 S SHIRLINGTON RD STE 1100
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-3605
Practice Address - Country:US
Practice Address - Phone:703-892-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
2509OtherBLUE CROSS BLUE SHIELD ID
MD1846ANOtherBLUE CROSS/BLUE SHIELD OF MD
0457470001OtherDURABLE MEDICAL EQUIPMENT
148820100OtherDEPT OF LABOR ID
0457470001Medicare NSC
0457470001OtherDURABLE MEDICAL EQUIPMENT
2509OtherBLUE CROSS BLUE SHIELD ID