Individual
WILLIAM STANTON ANDERSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
516 EAST NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1000
(505) 726-8740
Mailing address
1501 SAN PEDRO DR SE, # 182-C, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
(505) 256-6414
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11589
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115896
—
SC
Enumeration date
11/19/2005
Last updated
03/31/2017
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