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General NPI Number Information
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NPI Number | 1558599795
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Entity Type | Individual
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Provider Name | STEVEN GREGORY ANDERSON DO
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Gender | Male
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 365 LAKE HAVASU AVE S STE 102
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-9368
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Country | US
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Telephone | 928-459-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 365 LAKE HAVASU AVE S STE 102
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-9368
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Country | US
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Telephone | 928-459-2121
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Fax |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 05-39056
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License Number State | AZ
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