Provider Demographics
NPI:1972501534
Name:ANDERSON, CRAIG COLE (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:COLE
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7100 COMMERCE WAY
Mailing Address - Street 2:SUITE 180
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2829
Mailing Address - Country:US
Mailing Address - Phone:615-465-7000
Mailing Address - Fax:615-465-3007
Practice Address - Street 1:305 N BELLWOOD RD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-1120
Practice Address - Country:US
Practice Address - Phone:423-587-8200
Practice Address - Fax:423-587-8204
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN17726207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA98904Medicare UPIN
TN30247001Medicare PIN