Provider Demographics
NPI:1891714200
Name:ANDERSON, ERIC ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ANTHONY
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 US HIGHWAY 411 S
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-3104
Mailing Address - Country:US
Mailing Address - Phone:865-681-5277
Mailing Address - Fax:865-681-5278
Practice Address - Street 1:2732 US HIGHWAY 411 S
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-3104
Practice Address - Country:US
Practice Address - Phone:865-681-5277
Practice Address - Fax:865-681-5278
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001986111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4091848OtherBLUE CROSS BLUE SHEILD
TN4091848OtherBLUE CROSS BLUE SHEILD