WALLACE STEVE ANDERSON DO PC NPI 1982630109

NPI Information

  • NPI: 1982630109
  • Provider Name: WALLACE STEVE ANDERSON DO, PC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 1311 OCILLA RD
    DOUGLAS, GA
    ZIP 31533
  • Phone: (912) 384-1043

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NPI Details

WALLACE STEVE ANDERSON DO, PC is a family medicine in Douglas, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WALLACE STEVE ANDERSON DO, PC NPI is 1982630109. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1311 OCILLA RD
DOUGLAS, GA
ZIP 31533-213
Phone: (912) 384-1043

The provider's authorized official is Wallace S Anderson .
The authorized official title is Owner and has the following contact phone number (912) 384-1043.

The enumeration date for this NPI number is 6/23/2006 and was last updated on 12/10/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine028708GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP3122MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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