Anderson, Philip Bradley

Anderson, Philip Bradley is an individual health care provider with primary practice located at 2700 Se Stratus Ave , Mcminnville OR 97128-6255. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Anderson, Philip Bradley can be contacted via phone (615) 849-5685.

Contact Information

Primary practice address
2700 Se Stratus Ave Mcminnville OR 97128-6255
Phone: (615) 849-5685
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD18177 Tennessee
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD23029 Oregon

Profile Details

NPI number 1780673343
LBN Legal business name Anderson, Philip Bradley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Feb 15th, 2022 - about 4 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 1780673343 NPPES
Tennessee MEDICAID 3376285
Tennessee Other 4225056
Tennessee MEDICAID 500640579
Tennessee Other 0129072

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