Organization
ANDERSON PHYSICIAN ALLIANCE, INC.
Active
Other names
Baptist Medical Group-Anderson Physician Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY M DUCKETT (SR VP / CLO)
(901) 227-5233
Entity
Organization
Contact information
Practice address
2124 14TH ST, MERIDIAN, MS 39301-4040
(601) 703-3480
(601) 703-0124
Mailing address
PO BOX 2839, MERIDIAN, MS 39302-2839
(601) 703-3480
(601) 703-0124
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208800000X
Urology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
MS
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03604849
—
MS
05
—
127195
—
AL
Enumeration date
08/23/2010
Last updated
08/16/2024
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