Anderson, Kenneth Mark
Anderson, Kenneth Mark is an individual health care provider with primary practice located at 875 Union Ave Room C309, Memphis TN 38163-0001. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Pathology, which is considered as his primary health care specialty. Anderson, Kenneth Mark can be contacted via phone (901) 448-5876.Contact Information
Primary practice address
875 Union Ave Room C309
Memphis TN 38163-0001
Phone: (901) 448-5876
Fax: (901) 448-6835
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Pathology | 1223P0106X | DDS8053 | Tennessee |
Profile Details
| NPI number | 1245316017 |
|---|---|
| LBN Legal business name | Anderson, Kenneth Mark |
| Credentials | DDS,MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2006 |
| Last updated | Sep 5th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245316017 | NPPES |
| Tennessee | Other | 4075323 | BCBS |
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