Individual
MARK ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, UMMC - NEUROLOGY, JACKSON, MS 39216-4500
(601) 984-5517
Mailing address
2500 N STATE ST, UMMC - NEUROLOGY, JACKSON, MS 39216-4500
(601) 984-5517
(601) 984-5503
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
22703
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07276855
—
MS
05
—
P01266928
—
MS
Enumeration date
06/11/2007
Last updated
03/17/2014
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