Individual provider · NPI-1

Stephanie Demetric Anderson, MD

Family Medicine · Jackson, TN

NPI number1891084935
StatusActive
Last updated in NPPESJun 27, 2014

Details

NPI
1891084935
Entity type
Individual (NPI-1)
Name
Stephanie Demetric Anderson
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Mar 29, 2011
Last updated
Jun 27, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine46418KYYes

Practice location

294 Summar Dr
Jackson, TN 38301-3915

Phone 731-423-1932 · Fax 731-410-0367

Mailing address

294 Summar Dr
Jackson, TN 38301-3915

Phone 731-423-1932 · Fax 731-410-0367

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