Individual
KEITH G ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7460 WOLF RIVER BOULEVARD, GERMANTOWN, TN 38138
(901) 763-0200
(901) 761-4002
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
16687
TN
207RI0011X
Interventional Cardiology Physician
Primary
16687
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116765
—
MS
05
—
117803001
—
AR
05
—
1519975
—
TN
01
—
4270275
BCBS
TN
01
—
P00854010
RAILROAD MEDICARE
TN
Enumeration date
07/28/2005
Last updated
01/08/2024
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