Individual
JOHN G ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4575 N SHALLOWFORD RD, DUNWOODY, GA 30338-6445
(770) 454-4286
(770) 454-4065
Mailing address
PO BOX 70128, MARIETTA, GA 30007-0128
(770) 578-1800
(770) 578-6168
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN065882
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000550569L
—
GA
Enumeration date
05/24/2006
Last updated
01/07/2022
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