# ANTHONY ANDERSON

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1679524094
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 036119093 | IL | — |
| 207L00000X | Anesthesiology Physician | MDR7H67 | MO | — |
| 207Q00000X | Family Medicine Physician | 036119093 | IL | Yes |
| 208VP0000X | Pain Medicine Physician | 036119093 | IL | — |
| 208VP0014X | Interventional Pain Medicine Physician | 036119093 | IL | — |

## Other

- **Enumeration date:** 05/12/2006
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036119093 | — | IL |
| 01 | — | 200132704 | CDS | MO |
| 05 | — | 205069909 | — | MO |