Individual
JAY A. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
101 MANNING DR, CHAPEL HILL, NC 27599-0001
(919) 966-8596
(919) 843-5515
Mailing address
143 W FRANKLIN ST, CHAPEL HILL, NC 27516-2539
(919) 966-8596
(919) 843-5515
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
14786
SC
207L00000X
Anesthesiology Physician
Primary
29695
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
14786
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6911153
—
NC
05
—
TL5625
—
SC
Enumeration date
03/23/2006
Last updated
08/09/2012
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