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General NPI Number Information
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NPI Number | 1164845632
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Entity Type | Individual
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Provider Name | ANDREW JOSEPH ANDERSON D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/03/2014
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Last Update Date | 05/06/2019
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Provider Practice Location Address
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Address Line | 4327 BOONSBORO RD STE 5
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City | LYNCHBURG
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State | VA
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Zip | 24503
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Country | US
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Telephone | 434-214-0722
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Fax | 434-288-1211
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Provider Business Mailing Address
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Address Line | 4327 BOONSBORO RD STE 5
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City | LYNCHBURG
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State | VA
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Zip | 24503-2348
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Country | US
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Telephone | 434-214-0722
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Fax | 434-288-1211
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102204397
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R09580
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License Number State | IA
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