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NPI Code Detail

MEDICARE: ANDERSON MEDICAL PROCEDURES LLC

MEDICARE: ANDERSON MEDICAL PROCEDURES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1073166690
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANDERSON MEDICAL PROCEDURES LLC
Provider Business Mailing Address
First Line : 1355 RIVERSIDE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4368
Country : US
Telephone Number : 970-484-4620
Fax Number : 970-484-4645
Provider Business Practice Location Address
First Line : 1355 RIVERSIDE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4368
Country : US
Telephone Number : 970-484-4620
Fax Number : 970-484-4645
Authorized Official
Title or Position : SOLE OWNER
Name : DR. JAMES ANDERSON
Credential : DPM
Telephone Number : 970-227-3086
Provider Enumeration Date : 07/23/2019
Last Update Date : 12/12/2019

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