Anderson, Douglas Porter

Anderson, Douglas Porter is an individual health care provider with primary practice located at 101 Cunningham Dr , Ripley MS 38663-1302. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Anderson, Douglas Porter can be contacted via phone (662) 837-3011.

Contact Information

Primary practice address
101 Cunningham Dr Ripley MS 38663-1302
Phone: (662) 837-3011
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1235676792
LBN Legal business name Anderson, Douglas Porter
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2017
Last updated Nov 22nd, 2023 - about 2 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 1235676792 NPPES
Mississippi MEDICAID 03482206

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