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General NPI Number Information
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NPI Number | 1013336890
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Entity Type | Individual
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Provider Name | JEFFREY ANDERSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 9200 W WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53226
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Country | US
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Telephone | 215-707-3133
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Fax |
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Provider Business Mailing Address
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Address Line | 9200 W WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53226-3522
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Country | US
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Telephone | 414-955-1700
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Fax | 414-955-0072
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MD469835
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD469835
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 86109
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License Number State | WI
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