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:
Health care specialties
| Specialty | Code | License # | 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 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467492660 | NPPES |
| Tennessee | MEDICAID | 1454453 |
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