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General NPI Number Information
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NPI Number | 1467433979
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Entity Type | Individual
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Provider Name | TOM ANDERSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 1025 9TH ST #B
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City | CODY
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State | WY
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Zip | 82414-3441
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Country | US
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Telephone | 307-587-5622
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Fax | 307-587-5657
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Provider Business Mailing Address
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Address Line | PO BOX 30976
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City | BILLINGS
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State | MT
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Zip | 59107-0976
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Country | US
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Telephone | 406-238-6290
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Fax | 406-238-6961
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 9660
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 6512A
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License Number State | WY
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