Individual
DR. JOSEPH LEIF ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4319 LAWRENCEVILLE HWY NW, LILBURN, GA 30047-3416
(770) 921-4707
(770) 925-8973
Mailing address
4319 LAWRENCEVILLE HWY NW, LILBURN, GA 30047-3416
(770) 921-4707
(770) 925-8973
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1432
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410029607
MEDICARE RAILROAD
—
01
—
41ZCCRK
PTAN
—
Enumeration date
12/19/2005
Last updated
10/26/2015
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