Individual
DR. JEREMY R ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
120 12TH AVE E, ALEXANDRIA, MN 56308-2528
(320) 763-4321
(320) 763-6921
Mailing address
120 12TH AVE E, ALEXANDRIA, MN 56308-2528
(320) 763-4321
(320) 763-6921
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2725
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030701053
PRIMEWEST
MN
01
—
1027401
PREFERRED ONE
MN
01
—
140844
UCARE
MN
01
—
22-01217
MEDICA
MN
01
—
23375
AVESIS
MN
05
—
263685900
—
MN
01
—
410046064
RAILROAD MEDICARE
MN
01
—
43F52AN
BCBS
MN
01
—
HP31873
HEALTH PARTNERS
MN
Enumeration date
12/26/2006
Last updated
09/13/2011
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