Individual
MR. COLBY J ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
412 N 200 E, LOGAN, UT 84321-4038
(435) 713-2710
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10912261-1206
UT
363A00000X
Physician Assistant
PA1078
ID
363A00000X
Physician Assistant
PA3028
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35933330
—
CO
Enumeration date
07/10/2010
Last updated
04/03/2026
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