Individual
DR. KENNETH W. ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 PARK AVE, SUITE C, LEBANON, TN 37087-1706
(615) 444-4070
(615) 444-4099
Mailing address
PO BOX 190, LEBANON, TN 37088-0190
(615) 444-4070
(615) 444-4099
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD012869
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3010646
—
TN
01
—
40326
BCBS
TN
Enumeration date
10/02/2006
Last updated
03/18/2017
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