Individual
ANTHONY JAMAAL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT SMTP P.E.
Contact information
Practice address
295 DEBUYS RD, GULFPORT, MS 39507-2800
(228) 229-6865
Mailing address
295 DEBUYS RD, GULFPORT, MS 39507-2800
(228) 229-6865
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1408
MS
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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