Anderson, Mark Wesley

Anderson, Mark Wesley is an sole proprietor health care provider with primary practice located at 1079 Vendall Rd , Dyersburg TN 38024-1622. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist is his primary health care specialty. Anderson, Mark Wesley can be contacted via phone (731) 286-6006.

Contact Information

Primary practice address
1079 Vendall Rd Dyersburg TN 38024-1622
Phone: (731) 286-6006
Fax: (731) 286-5570
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist 222Z00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist 224P00000X

Profile Details

NPI number 1467492660
LBN Legal business name Anderson, Mark Wesley
Credentials CPO
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 7th, 2006
Last updated Mar 25th, 2008 - about 16 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 1467492660 NPPES
Tennessee MEDICAID 1454453

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