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NPI Code Detail

MEDICARE: KATHY J ANDERSON M.D.

MEDICARE: KATHY 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
1208D00000XGeneral Practice Physician22911IA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3080122362OTHERIARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
245019OTHERIAWELLMARK/BLUE CROSS
4IA0121OTHERIAJOHN DEERE HEALTH CARE
525671OTHERIAIOWA HEALTH SOLUTIONS

General Provider Information

NPI Number : 1285636100
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHY J ANDERSON M.D.
Provider Business Mailing Address
First Line : 5409 AVENUE O
Second Line :
City : FORT MADISON
State : IA
Zip : 52627-9601
Country : US
Telephone Number : 319-376-2134
Fax Number : 319-376-2188
Provider Business Practice Location Address
First Line : 5409 AVENUE O
Second Line :
City : FORT MADISON
State : IA
Zip : 52627-9601
Country : US
Telephone Number : 319-376-2134
Fax Number : 319-376-2188
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 04/27/2021

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Directions to “ KATHY J ANDERSON M.D.” Practice Location

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