Mark A Anderson, PT, PHD, ATC
Individual provider Active NPI Physical Therapist · Oklahoma City, OK
NPI 1821145368 · NPPES record last updated Jul 10, 2007
Key facts
- NPI
- 1821145368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- OK940 (OK)
- Practice address
- 1600 N Phillips Ave
Oklahoma City, OK 73104-4619 - Phone
- (405) 271-2131
- Fax
- (405) 271-2432
- NPI assigned
- Jan 5, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 940 | OK | MD | Marriage & Family Therapist |
| OK940 | OK | MD | Physical Therapist |
| 190 | OK | MD | Recreation Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | OK940 | OK | Yes |
| Sports Physical Therapist | 2251S0007X | 190 | OK |
Addresses
Primary practice location
1600 N Phillips Ave
Oklahoma City, OK 73104-4619
Mailing address
801 NE 13TH St
Room 239
Oklahoma City, OK 73104-5005
Phone (405) 271-2131
Other providers in Oklahoma City, OK
- Latoya Rena Anderson
- Lavone Marie Anderson
- Lori Suzette Anderson
- Maren Alenka Anderson
- Mark Anderson
- Mary Pearson Anderson
- Matthew Anderson
- Matthew Shelton Anderson
- Melissa J Anderson
- Mia Anderson
All providers in Oklahoma City, OK · Physical Therapist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 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.