Paul M Anderson, MD
Individual provider Active NPI Specialist · Van Buren, AR
NPI 1720174733 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720174733
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- R-1979 (AR)
- Practice address
- 2010 Chestnut
Suite F
Van Buren, AR 72956 - Phone
- (479) 471-4150
- Fax
- (479) 471-4188
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-1979 | AR | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Correct Care, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | R-1979 | AR | Yes |
Addresses
Primary practice location
2010 Chestnut
Suite F
Van Buren, AR 72956
Mailing address
PO Box 378
Van Buren, AR 72957-0378
Phone (479) 452-2048
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18155000040 | Other | AR | DUAL CHOICE |
| 50113 | Other | AR | BCBS |
Other providers in Van Buren, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.