Anderson, Jack W.

Anderson, Jack W. is an individual health care provider with primary practice located at 470 Taylor Rd , Montgomery AL 36117-3563. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Anderson, Jack W. can be contacted via phone (334) 226-4048.

Contact Information

Primary practice address
470 Taylor Rd Montgomery AL 36117-3563
Fax: (334) 323-5675
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD.16671 Alabama

Profile Details

NPI number 1811964000
LBN Legal business name Anderson, Jack W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2006
Last updated Sep 26th, 2019 - about 7 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 1811964000 NPPES
Alabama Other 050071018 MEDICARE RR
Alabama Other 510-45874 MEDICARE RR
Alabama MEDICAID 214426 MEDICARE RR

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