Individual
DR. GRETCHEN NICOLE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3825 MEDICAL PARK DR STE 100, AUSTELL, GA 30106-6831
(470) 267-1760
Mailing address
500 W 3RD AVE STE 101, ALBANY, GA 31701-1900
(229) 312-5800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101018961
MI
207RG0100X
Gastroenterology Physician
075910
GA
207RG0100X
Gastroenterology Physician
34.015547
OH
207RG0100X
Gastroenterology Physician
Primary
76269
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5315046810
CONTROLLE SUBSTANCE LICENSE
MI
Enumeration date
04/06/2011
Last updated
03/27/2025
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