# ANDERSON REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ANDERSON REGIONAL MEDICAL CENTER
- **Other names:** Anderson Multispecialty Providers
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376040121
- **Legal business name:** ANDERSON REGIONAL MEDICAL CENTER
- **Authorized official:** JOHN ANDERSON (CEO/PRESIDENT)
- **Authorized official phone:** (601) 553-6104

## Contact information

- **Practice address:** 2124 14TH ST, MERIDIAN, MS 39301-4040
- **Practice address phone:** (601) 703-3480
- **Practice address fax:** (601) 703-0124
- **Mailing address:** 2124 14TH ST, MERIDIAN, MS 39301-4040
- **Mailing address phone:** (601) 703-3480
- **Mailing address fax:** (601) 703-0124

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 2085R0001X | Radiation Oncology Physician | — | NULL | — |
| 2085R0001X | Radiation Oncology Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/09/2018
- **Last updated:** 04/09/2018