MEDICARE: DAVID ROBERT ANDERSON DO

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	3126	OK

General Provider Information

NPI Number	:	1780788158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ROBERT ANDERSON DO

Provider Business Mailing Address
First Line	:	4301 MOW-WAY ROAD
Second Line	:	REYNOLDS ARMY COMMUNITY HOSPITAL(ATTN:MCUA-QC,MS PRESCO
City	:	FORT SILL
State	:	OK
Zip	:	73503-6300
Country	:	US
Telephone Number	:	580-458-2134
Fax Number	:	580-458-2314

Provider Business Practice Location Address
First Line	:	4301 MOW-WAY ROAD
Second Line	:	REYNOLDS ARMY COMMUNITY HOSPITAL(ATTN:MCUA-QC,MS PRESCO
City	:	FORT SILL
State	:	OK
Zip	:	73503-6300
Country	:	US
Telephone Number	:	580-458-2134
Fax Number	:	580-458-2314

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

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	02/24/2025

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