Anderson Family Practice

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ANDERSON FAMILY PRACTICE

Practice address

3505 Broadway St
Mount Vernon, IL 62864-2202

Phone

(618) 244-7788

Fax

(618) 244-9330

NPI assigned

Apr 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Alan W Anderson, MD

Title

President

Phone

(618) 244-7788

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023235348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N 27TH ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642924",
            "telephone_number": "618-244-3245",
            "fax_number": "618-244-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 BROADWAY ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642202",
            "telephone_number": "618-244-7788",
            "fax_number": "618-244-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-244-7788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany L Alms, RN
• Suzanne E Alt, DO
• Michael Ambrose, MD
• American Homepatient, Inc.
• Rahulkumar Amrutiya
• Kathleen Anderson
• Sarah Anderson, P.T.
• Carla Jenell Andrews, RN
• Anesthesia Associates of Southern Illinois Surgery Center LLC
• Anesthesia Associates of Southern Illinois, LLC

• Primary Care Clinic/Center in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.