Individual
MR. PAUL R. ANDERSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 249-5500
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1072774
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
875933
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00107335
—
MS
Enumeration date
05/16/2006
Last updated
09/17/2025
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