MEDICARE: CLAUDE ANDERSON OD

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
1	152W00000X	Optometrist	18002946B	IN

General Provider Information

NPI Number	:	1265574313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDE ANDERSON OD

Provider Business Mailing Address
First Line	:	4150 LAFAYETTE RD
Second Line	:	C
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-5443
Country	:	US
Telephone Number	:	317-280-0114
Fax Number	:	317-280-0117

Provider Business Practice Location Address
First Line	:	4150 LAFAYETTE RD
Second Line	:	C
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-5443
Country	:	US
Telephone Number	:	317-280-0114
Fax Number	:	317-280-0117

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/08/2007

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Directions to “ CLAUDE ANDERSON OD” Practice Location

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