Individual
DR. JOHN A ANDERSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
106 WESTSIDE DR, TULLAHOMA, TN 37388-3253
(931) 454-9768
(931) 454-9769
Mailing address
106 WESTSIDE DR, TULLAHOMA, TN 37388-3253
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15979
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3013276
—
TN
01
—
45070
BCBS
TN
Enumeration date
08/18/2006
Last updated
07/08/2007
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