Individual
JACOB ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3911 AVENUE B, SCOTTSBLUFF, NE 69361-4617
(308) 630-2100
(308) 630-1349
Mailing address
260895 COUNTY RD E # 1, SCOTTSBLUFF, NE 69361-6907
(435) 754-8044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3013
NE
207Q00000X
Family Medicine Physician
DR.0063543
CO
Other
Enumeration date
05/04/2018
Last updated
10/03/2025
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