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THOMAS L ANDERSON M.D.
Adolescent Medicine >> Pediatrics >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1033169321
Individual Registrant: THOMAS L ANDERSON M.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
105 W CRANFORD AVE VALDOSTA, GA 31602-2930 US
Tel: 229-247-7350 Fax: 229-242-1730
Tel: 229-247-7350 Fax: 229-242-1730
Contact information for business:
105 W CRANFORD AVE VALDOSTA, GA 31602-2930 US
Tel: 229-247-7350 Fax: 229-242-1730
Tel: 229-247-7350 Fax: 229-242-1730
Registration Information:
NPI: 1033169321
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 2080A0000X | Allopathic & Osteopathic Physicians Pediatrics Adolescent Medicine | GA | 025093 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| MEDICARE PART B | 202I370889 | GA | 01 |
| 264389800 | FL | 05 | |
| 00271543A | GA | 05 |
