Provider Demographics
NPI:1487755443
Name:ANDERSON, THOMAS GORDON (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GORDON
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 H ESTATE SOLBERG
Mailing Address - Street 2:
Mailing Address - City:ST. THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802
Mailing Address - Country:US
Mailing Address - Phone:340-715-1571
Mailing Address - Fax:
Practice Address - Street 1:RED HOOK PLAZA
Practice Address - Street 2:SUITE 205
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-775-2303
Practice Address - Fax:340-779-2077
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1209207P00000X
VIVI 1209207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VIBA2890146OtherEMERGENCY MEDICINE
VIVI 1209OtherFAMILY MEDICINE