Anderson, Willie Thomas

Anderson, Willie Thomas is an sole proprietor health care provider with primary practice located at 378 Marketplace Blvd Ste 10C , Johnson City TN 37604-2361. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, which is considered as his primary health care specialty. Anderson, Willie Thomas can be contacted via phone (423) 431-4946.

Contact Information

Primary practice address
378 Marketplace Blvd Ste 10C Johnson City TN 37604-2361
Phone: (423) 431-4946
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X MD0000039211 Tennessee

Profile Details

NPI number 1851448476
LBN Legal business name Anderson, Willie Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 4th, 2007
Last updated Jun 5th, 2024 - about last year

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 1851448476 NPPES
Tennessee Other MD0000039211 STATE MEDICAL LICENSE
Tennessee MEDICAID 332756 STATE MEDICAL LICENSE

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