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General NPI Number Information
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NPI Number | 1750302568
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Entity Type | Individual
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Provider Name | JOSEPH ANDERSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 10/17/2018
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Provider Practice Location Address
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Address Line | 163 VETERANS DRIVE
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City | WHITE RIVER JUNCTION
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State | VT
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Zip | 05009-0001
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Country | US
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Telephone | 802-295-9363
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Fax |
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Provider Business Mailing Address
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Address Line | 14 BARRETT RD
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City | HANOVER
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State | NH
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Zip | 03755-2421
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Country | US
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Telephone | 603-277-9438
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 185815
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License Number State | NY
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