Individual
DR. JEREMY WADE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1642 MCARTHUR ST, MANCHESTER, TN 37355-2522
(931) 728-1315
(931) 728-1779
Mailing address
1642 MCARTHUR ST, MANCHESTER, TN 37355-2522
(931) 728-1315
(931) 728-1779
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2431
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2431
LICENSE OD
TN
05
—
3946295
—
TN
Enumeration date
08/24/2005
Last updated
01/14/2013
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