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NPI Code Detail

MEDICARE: DR. KEITH DAVID ANDERSON PHARM.D.

MEDICARE: DR. KEITH DAVID ANDERSON PHARM.D.
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
11835P1300XPsychiatric Pharmacist10383KS

General Provider Information

NPI Number : 1871590604
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEITH DAVID ANDERSON PHARM.D.
Provider Business Mailing Address
First Line : 11292 HADLEY ST
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66210-2410
Country : US
Telephone Number : 913-722-6456
Fax Number : 816-922-3317
Provider Business Practice Location Address
First Line : 4801 E LINWOOD BLVD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64128-2226
Country : US
Telephone Number : 816-861-4700
Fax Number : 816-922-3317
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/08/2007

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