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Individual

DR. AMOS ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5400 BOWMAN RD, SUITE 100, MACON, GA 31210-8879
(478) 745-6576
(478) 746-0018
Mailing address
5400 BOWMAN RD, SUITE 100, MACON, GA 31210-8879
(478) 745-6576
(478) 746-0018

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
19632
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000178406B
GA
01
063760
BC/BS NUMBER
GA
01
110010866
RAILROAD MEDICARE
GA
Enumeration date
08/10/2006
Last updated
07/23/2013
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