Individual
DR. PAUL M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2010 CHESTNUT, SUITE F, VAN BUREN, AR 72956
(479) 471-4150
(479) 471-4188
Mailing address
PO BOX 378, VAN BUREN, AR 72957-0378
(479) 452-2048
(479) 452-2048
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R-1979
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18155000040
DUAL CHOICE
AR
01
—
50113
BCBS
AR
Enumeration date
10/05/2006
Last updated
07/08/2007
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