Individual
LISA D ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
935 HIGHWAY 51, MADISON, MS 39110-8407
(601) 856-5986
Mailing address
308 CORPORATE DR, RIDGELAND, MS 39157-8803
(601) 898-7500
(601) 898-7577
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
16045
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122742
—
MS
Enumeration date
06/29/2006
Last updated
02/09/2016
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