Provider Demographics
NPI:1942257118
Name:THE ANDERSEN CLINIC PC
Entity Type:Organization
Organization Name:THE ANDERSEN CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:828-684-4595
Mailing Address - Street 1:5045 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-6606
Mailing Address - Country:US
Mailing Address - Phone:828-684-4595
Mailing Address - Fax:828-687-3746
Practice Address - Street 1:5045 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732-6606
Practice Address - Country:US
Practice Address - Phone:828-684-4595
Practice Address - Fax:828-687-3746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2338279Medicare ID - Type Unspecified
NCF26773Medicare UPIN