Mark Wesley Anderson
Podiatrist Prosthetist
1079 Vendall Rd
Dyersburg
, Tennessee 38024-1622
Mark Wesley Anderson
Podiatrist Prosthetist
1079 Vendall Rd
Dyersburg
, Tennessee 38024-1622
(731) 286-5570
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About
Features
Specialties
- Podiatrist
- Prosthetist
Languages spoken
- English
Location
First Address
- Mark Wesley Anderson
- 659 Anderson Rd
- Dyersburg, TN
- Zip : 38024-8401
- Fax : (731) 286-5570
- Phone : (731) 286-6006
Second Address
- Mark Wesley Anderson
- 1079 Vendall Rd
- Dyersburg, TN
- Zip : 38024-1622
- Fax : (731) 286-5570
- Phone : (731) 286-6006
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 213E00000X | Podiatrist | ||
| N | 222Z00000X | Podiatrist | ||
| Y | 224P00000X | Prosthetist |
National Provider Identifier
| NPI | 1467492660 |
|---|---|
| Provider Name | Mark Wesley Anderson |
| First Address | Dyersburg, TN 38024-8401 |
| Second Address | Dyersburg, TN 38024-1622 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/06/2006 |
| Last Update Date | 25/03/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1454453 | (05) | TN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.