MEDICARE: DR. PETER KNOX ANDERSON O.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
1	152W00000X	Optometrist	OE 006503T	PA

General Provider Information

NPI Number	:	1558373407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER KNOX ANDERSON O.D.

Provider Business Mailing Address
First Line	:	71 CRABTREE DR
Second Line	:
City	:	LEVITTOWN
State	:	PA
Zip	:	19055-1617
Country	:	US
Telephone Number	:	215-946-8478
Fax Number	:	267-202-6887

Provider Business Practice Location Address
First Line	:	71 CRABTREE DR
Second Line	:
City	:	LEVITTOWN
State	:	PA
Zip	:	19055-1617
Country	:	US
Telephone Number	:	215-946-8478
Fax Number	:	267-202-6887

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

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	09/15/2014

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