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NPI Code Detail

MEDICARE: DR. KEVIN J ANDERSON M.D.

MEDICARE: DR. KEVIN J ANDERSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician35058383OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114921988
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN J ANDERSON M.D.
Provider Business Mailing Address
First Line : 5450 FRANTZ RD STE 360
Second Line :
City : DUBLIN
State : OH
Zip : 43016-4141
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7630 RIVERS EDGE DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43235-1329
Country : US
Telephone Number : 614-533-4000
Fax Number : 614-540-3979
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 07/11/2024

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