Individual
PHILIP BRADLEY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2700 SE STRATUS AVE, MCMINNVILLE, OR 97128-6255
(615) 849-5685
Mailing address
2700 SE STRATUS AVE, MCMINNVILLE, OR 97128-6255
(615) 849-5685
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD18177
TN
2084P0800X
Psychiatry Physician
Primary
MD23029
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0129072
BLUE CROSS BLUE SHIELD
TN
05
—
3376285
—
TN
01
—
4225056
AETNA
—
05
—
500640579
—
OR
Enumeration date
10/17/2005
Last updated
02/15/2022
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