Healthcare Provider Details

I. General information

NPI: 1154302677
Provider Name (Legal Business Name): SCOTT A ANDERSON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 E BROADWAY STE 100
COLUMBIA MO
65201-7167
US

IV. Provider business mailing address

1705 E BROADWAY STE 100
COLUMBIA MO
65201-7167
US

V. Phone/Fax

Practice location:
  • Phone: 573-874-7800
  • Fax: 573-443-3627
Mailing address:
  • Phone: 573-874-7800
  • Fax: 573-443-3627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberR8G43
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberR8G43
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: