Individual
JAMES KYLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
47836
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0147121
—
MT
05
—
0599407
—
IA
01
—
1044923
PREFERRED ONE
—
01
—
135228
UCARE
MN
01
—
153841
FV CAREGIVER
MN
01
—
19-00018
MEDICA PRIMARY
MN
01
—
19-00701
MEDICA CHOICE
MN
05
—
210077100
—
MN
01
—
2380609
AMERICA'S PPO (ARAZ)
—
05
—
34708900
—
WI
01
—
B666
CHAMPUS
—
01
—
HP55786
HEALTHPARTNERS
—
Enumeration date
09/11/2006
Last updated
10/23/2017
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