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General NPI Number Information
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NPI Number | 1316309891
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Entity Type | Organization
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Legal Business Name | DR. HARRY J.ANDERSON,JR.,M.D.
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | 190 E CHEYENNE MOUNTAIN BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3718
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Country | US
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Telephone | 719-576-7337
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Fax |
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Provider Business Mailing Address
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Address Line | 190 E CHEYENNE MOUNTAIN BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3718
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Country | US
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Telephone | 719-576-7337
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JANIECE CARLSON
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Credential |
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Telephone | 719-576-7921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 21329
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License Number State | CO
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