Organization
CHARLES E ANDERESON MD PC
Active
Other names
Tullahoma Laser Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES E ANDERSON MD (PRESIDENT)
(931) 393-0600
Entity
Organization
Contact information
Practice address
2336 N JACKSON ST, TULLAHOMA, TN 37388
(931) 393-0600
(931) 393-0656
Mailing address
2336 N JACKSON ST, PO BOX 1840, TULLAHOMA, TN 37388
(931) 393-0600
(931) 393-0656
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD14122
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3197128
—
TN
01
—
4009762
BCBS OF TN
TN
01
—
7240951
CIGNA HEALTH CARE
TN
Enumeration date
05/19/2006
Last updated
08/22/2020
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