Individual
DR. JACOB DOUGLAS ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
630 E 1400 N STE 150, LOGAN, UT 84341-2549
(435) 915-4465
(435) 787-8509
Mailing address
740 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(208) 542-9111
(208) 542-9114
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
7942683-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205300407
NPI
ID
01
—
833011825
STATE
ID
Enumeration date
06/26/2015
Last updated
07/08/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us