Individual
ANSEL GLEN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4220 HARDING RD, NASHVILLE, TN 37205-2005
(615) 222-2111
Mailing address
PO BOX 3490, CLARKSVILLE, TN 37043-3490
(931) 647-5034
(931) 552-6663
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD40430
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3335732
—
TN
01
—
4118861
BCBS PROVIDER NUMBER
TN
01
—
P00313053
RAILROAD MEDICARE
TN
Enumeration date
05/18/2006
Last updated
04/14/2008
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