MEDICARE: DR. JAMES H. ANDERSON D.O.

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	207Q00000X	Family Medicine Physician	2271	OK

General Provider Information

NPI Number	:	1932184280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES H. ANDERSON D.O.

Provider Business Mailing Address
First Line	:	1202 WEST FARM ROAD
Second Line	:
City	:	STILLWATER
State	:	OK
Zip	:	74078-2036
Country	:	US
Telephone Number	:	405-744-7024
Fax Number	:	405-744-6556

Provider Business Practice Location Address
First Line	:	1202 WEST FARM ROAD
Second Line	:
City	:	STILLWATER
State	:	OK
Zip	:	74078-2036
Country	:	US
Telephone Number	:	405-744-7024
Fax Number	:	405-744-6556

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

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	09/10/2008

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