Individual
MR. DOUGLAS PORTER ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
101 CUNNINGHAM DR, RIPLEY, MS 38663-1302
(662) 837-3011
Mailing address
4637 WHITECHAPEL LN, BELDEN, MS 38826-9780
(662) 255-2163
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03482206
—
MS
Enumeration date
01/23/2017
Last updated
11/12/2025
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