MEDICARE: DR. DANIER DESELLE ANDERSON D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	DPM.200039	LA

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	:	1639347073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIER DESELLE ANDERSON D.P.M.

Provider Business Mailing Address
First Line	:	8649 HIGHWAY 165 N STE 1
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71203-8965
Country	:	US
Telephone Number	:	318-283-3980
Fax Number	:	318-239-8980

Provider Business Practice Location Address
First Line	:	8649 HIGHWAY 165 N STE 1
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71203-8965
Country	:	US
Telephone Number	:	318-283-3980
Fax Number	:	318-239-8980

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

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	06/24/2025

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Directions to “ DR. DANIER DESELLE ANDERSON D.P.M.” Practice Location

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