Individual
STEPHANIE DEMETRIC ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
294 SUMMAR DR, JACKSON, TN 38301-3915
(731) 423-1932
(731) 410-0367
Mailing address
294 SUMMAR DR, JACKSON, TN 38301-3915
(731) 423-1932
(731) 410-0367
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46418
KY
Other
Enumeration date
03/29/2011
Last updated
06/27/2014
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