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Individual

DR. DALE JOHNSON ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6365 CLAYTON ROAD, ST LOUIS, MO 63117
(314) 645-1567
(314) 725-4449
Mailing address
6365 CLAYTON ROAD, ST LOUIS, MO 63117
(314) 645-1567
(314) 725-4449

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R2E00
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007924000
MAGELLAN
01
012043
VALUEOPTIONS
01
132483
HEALTHLINK
01
1521222
UNITED BEHAVIORAL HEALTH
01
25961
BLUE CROSS BLUE SHIELD
MO
01
33326
IBEW
01
B18373
MERCY HEALTH PLANS
Enumeration date
09/26/2006
Last updated
02/05/2020
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