Anderson, Charles Edward

Anderson, Charles Edward is an sole proprietor health care provider with primary practice located at 4800 I-55 North , Jackson MS 39211-5555. He recently has only one registered license in Eye and Vision Services Providers / Ocularist, which is considered as his primary health care specialty. Anderson, Charles Edward can be contacted via phone (601) 948-0582.

Contact Information

Primary practice address
4800 I-55 North Jackson MS 39211-5555
Fax: (601) 362-1392
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Ocularist 156FX1700X UNLICENSED STATE Mississippi

Profile Details

NPI number 1316004039
LBN Legal business name Anderson, Charles Edward
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2007
Last updated Dec 12th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316004039 NPPES
Mississippi MEDICAID 00089008

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