Individual
DR. LARRY W. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
81 NORTHSIDE DAWSON DR, STE 205, DAWSONVILLE, GA 30534-7166
(706) 265-1335
(706) 265-2296
Mailing address
81 NORTHSIDE DAWSON DR, STE 205, DAWSONVILLE, GA 30534-7166
(706) 265-1335
(706) 265-2296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
020648
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003138628A
—
GA
01
—
08BCBCN
LEGACY
GA
01
—
P00419457
RAILROAD MEDICARE PTAN
GA
Enumeration date
05/04/2006
Last updated
08/07/2020
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