Individual
JON T ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 CYPRESS, #110, ABILENE, TX 79601-5122
(325) 677-2201
(325) 677-7641
Mailing address
PO BOX 2898, ABILENE, TX 79604-2898
(325) 677-2201
(325) 677-7641
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
23503
NE
2085R0202X
Diagnostic Radiology Physician
Primary
M8493
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23503
STATE LICENSE
NE
01
—
M8493
STATE LICENSE
TX
Enumeration date
02/20/2007
Last updated
06/27/2012
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