Organization
LARRY W ANDERSON, DO, LLC
Active
Other names
Anderson Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY W ANDERSON DO (MANAGING MEMBER)
(706) 265-1335
Entity
Organization
Contact information
Practice address
6002 HIGHWAY 53 E, DAWSONVILLE, GA 30534-6227
(706) 265-1335
(706) 265-2296
Mailing address
6002 HIGHWAY 53 E, DAWSONVILLE, GA 30534-6227
(706) 265-1335
(706) 265-2296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
020648
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG1560
RAILROAD MEDICARE GRP #
GA
01
—
GRP7339
MEDICARE LEGACY
—
Enumeration date
12/06/2006
Last updated
11/27/2007
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