Individual
MADISON ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15837 PAUL VEGA MD DR STE 200, HAMMOND, LA 70403-1495
(985) 230-7730
Mailing address
PO BOX 2668, BUSINESS CTR - INS CREDENTIALING, HAMMOND, LA 70404-2668
(985) 230-1682
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
343175
LA
Other
Enumeration date
07/11/2024
Last updated
10/11/2024
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