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General NPI Number Information
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NPI Number | 1841310166
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Entity Type | Organization
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Legal Business Name | CHAD W. ANDERSON, M.D., P.C.
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 1811 W ROYAL HUNTE DR STE 1
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City | CEDAR CITY
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State | UT
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Zip | 84720-8274
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Country | US
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Telephone | 435-586-1131
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Fax | 435-865-1121
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Provider Business Mailing Address
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Address Line | 1811 W ROYAL HUNTE DR STE 1
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City | CEDAR CITY
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State | UT
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Zip | 84720-8274
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Country | US
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Telephone | 435-586-1131
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Fax | 435-865-1121
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. CHAD W. ANDERSON
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Credential | M.D.
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Telephone | 435-586-1131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 290405-1205
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License Number State | UT
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