Individual
DAPHNE K ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3000
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
36538
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025014838
MEDICARE PTAN
MO
01
—
107052
BLUE CROSS/BLUE SHIELD
—
05
—
202388328
—
MO
Enumeration date
06/04/2006
Last updated
02/06/2013
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