Individual
DR. OTIS ANDERSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5185 GETWELL RD, SOUTHAVEN, MS 38671-9691
(662) 893-6300
Mailing address
5147 WEMBERLEY DRIVE, MEMPHIS, TN 38125
(901) 240-8937
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
21754
MS
Other
Enumeration date
05/02/2007
Last updated
10/13/2011
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