Anderson, Mark R

Anderson, Mark R is an individual health care provider with primary practice located at 800 E Dawson St , Tyler TX 75701-2036. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Anderson, Mark R can be contacted via phone (903) 593-8441.

Contact Information

Primary practice address
800 E Dawson St Tyler TX 75701-2036
Phone: (903) 593-8441
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X J0423 Texas

Profile Details

NPI number 1346289055
LBN Legal business name Anderson, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Jul 10th, 2015 - about 9 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 1346289055 NPPES
Texas MEDICAID 130578109
Texas Other 75-0818167-048
Texas Other 8L1047
Texas Other 750818167-044
Texas Other 015
Texas Other P01464103
Texas MEDICAID 130578103
Texas Other 75-2616977-001
Texas Other 75-2616977-028
Texas Other 8DQ330
Texas Other 750818167022
Texas Other 990014514
Texas Other 005
Texas MEDICAID 130578110
Texas Other 75-2616977-002
Texas Other 8EX117
Texas Other 0061EK
Texas MEDICAID 130578107
Texas MEDICAID 130578108

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