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MARY C ANDERSON MD
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1083611057
Individual Registrant: MARY C ANDERSON MD
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
4100 HARRISON ST BATESVILLE, AR 72501-9419 US
Tel: 870-307-0001 Fax: 870-307-0395
Tel: 870-307-0001 Fax: 870-307-0395
Contact information for business:
PO BOX 497 AUGUSTA, AR 72006-0497 US
Tel: 870-347-2534 Fax: 870-347-3492
Tel: 870-347-2534 Fax: 870-347-3492
Registration Information:
NPI: 1083611057
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | AR | E-1905 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 138378001 | AR | 05 | |
| RAILROAD MEDICARE | 080189277 | 01 |
