MEDICARE: DEBORAH A ANDERSON MD

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
1	207Q00000X	Family Medicine Physician	430518	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538168851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH A ANDERSON MD

Provider Business Mailing Address
First Line	:	325 MAINE STREET
Second Line	:	MSO LIBRARY
City	:	LAWRENCE
State	:	KS
Zip	:	66044-1360
Country	:	US
Telephone Number	:	785-505-2988
Fax Number	:	785-505-5228

Provider Business Practice Location Address
First Line	:	1130 W 4TH ST STE 3200
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66044-1346
Country	:	US
Telephone Number	:	785-505-5850
Fax Number	:	785-505-5268

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	11/24/2020

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Directions to “ DEBORAH A ANDERSON MD” Practice Location

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