Individual
CHARLES B ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
131 TUCKER STREET, SUITE 5, JACKSON, TN 38301
(931) 388-6404
(931) 388-7119
Mailing address
410 N CEDAR BLUFF RD, STE 300, KNOXVILLE, TN 37923-3632
(931) 388-6404
(931) 388-7119
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD16686
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3026238
—
TN
Enumeration date
02/17/2006
Last updated
05/18/2016
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