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Individual

DR. PERCY L ANDERSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M., C.W.S., CMET

Contact information

Practice address
1815 HOSPITAL DR, SUITE 434, JACKSON, MS 39204-3425
(601) 502-1100
(601) 502-0111
Mailing address
PO BOX 1533, SUITE 434, MADISON, MS 39130-1533
(601) 502-1100
(601) 502-0111

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
80107
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05984200
MS
01
640813898
UNITED HEALTH CARE
MS
Enumeration date
10/11/2006
Last updated
04/01/2016
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