Individual
DEREK JAMES ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9001 SUMMA AVE, BATON ROUGE, LA 70809-3726
(225) 761-5200
(225) 761-5487
Mailing address
1514 JEFFERSON HWY, BLDG 200, NEW ORLEANS, LA 70121-2429
(225) 237-1754
(225) 237-1722
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10793R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00876731
—
MS
01
—
080179869
RAILROAD MEDICARE PIN
LA
05
—
1996254
—
LA
01
—
270663YJGU
MEDICARE PTAN
LA
01
—
990008020
RAILROAD MEDICARE PIN
LA
Enumeration date
06/28/2005
Last updated
04/29/2016
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