Individual
DR. ANDREW JOSEPH ANDERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5571
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5571
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
19073
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09356273
—
MS
05
—
174885
—
AL
01
—
512G700003
MS MEDICARE - GROUP
MS
01
—
P00462155
MEDICARE RR
MS
Enumeration date
11/07/2006
Last updated
08/28/2015
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