Individual
MR. MELVIN M ANDERSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
507 MARKET ST, PORT GIBSON, MS 39150-2041
(601) 618-3728
Mailing address
PO BOX 124, PORT GIBSON, MS 39150-0124
(601) 618-3728
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
251300000X
Local Education Agency (LEA)
—
—
251X00000X
Supports Brokerage Agency
Primary
—
—
374U00000X
Home Health Aide
—
MS
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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