Edwin Alexander Anders, MD

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

S8148 Issued in TX

Practice address

11937 US Highway 271
Tyler, TX 75708-3154

Phone

(318) 789-7378

Fax

(903) 877-7651

NPI assigned

Apr 23, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1174943617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DIVISION ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154",
            "telephone_number": "318-789-7378",
            "fax_number": "903-877-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERS",
        "first_name": "EDWIN",
        "middle_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TX",
            "license": "S8148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05029898",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mavis Ameyaa, MSN, APRN, FNP-C
• Charmiah Amie
• Francesca O Amoje
• Amy Furqueron, LLC
• Nkechi Alexandra Anako
• Latonia Anders
• Anderson Podiatry PLLC
• Alan Anderson
• Alonna R Anderson
• Anthony Anderson, P.A.

• Public Health & General Preventive Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Public Health & General Preventive Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.