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Individual

KEITH CHARLES ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
201 GOVERNORS DRIVE, 1ST FLOOR, HUNTSVILLE, AL 35801-5123
(256) 533-8100
(256) 533-8101
Mailing address
PO BOX 4799, HUNTSVILLE, AL 35815-4799
(256) 539-4545
(256) 539-4990

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
DO250
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000083822
AL
01
1451629
UNITED MINE WORKERS
01
167578000
US DEPT OF LABOR
01
180012766
MC RR
05
4046275
TN
01
8045502
CIGNA
01
83822
BLUE CROSS
AL
Enumeration date
12/06/2005
Last updated
12/11/2008
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