Individual
GARY E ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
210 W 53RD ST, DAVENPORT, IA 52806-2251
(563) 386-3436
(563) 386-3211
Mailing address
865 LINCOLN RD, STE L10, BETTENDORF, IA 52722-4159
(563) 355-9191
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01552
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034792
HEALTH ALLIANCE
—
05
—
1160432
—
IA
01
—
20100
IOWA HEALTH SOLUTIONS
—
01
—
40197
WELLMARK BC/BS
IA
01
—
4796890009
DMERC
—
01
—
IA0104
JOHN DEERE HEALTH PLAN
—
Enumeration date
06/16/2005
Last updated
07/09/2007
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