Provider Demographics
NPI:1437285574
Name:LETT-ANDERSON, PAULINE A (MD)
Entity type:Individual
Prefix:DR
First Name:PAULINE
Middle Name:A
Last Name:LETT-ANDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAULINE
Other - Middle Name:A
Other - Last Name:LETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22454 US HIGHWAY 72 STE 330
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-2609
Mailing Address - Country:US
Mailing Address - Phone:256-262-6380
Mailing Address - Fax:
Practice Address - Street 1:22454 US HIGHWAY 72 STE 330
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-2609
Practice Address - Country:US
Practice Address - Phone:256-262-6380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-25
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39635207RI0200X
NC2007-01211207RI0200X
AL38375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease