Individual
PAUL S ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2701 FOX RUN PKWY, YANKTON, SD 57078-5350
(605) 665-7762
(605) 725-2614
Mailing address
310 8TH AVE NW STE 503, ABERDEEN, SD 57401-2369
(605) 225-2020
(605) 725-2614
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
123
SD
152W00000X
Optometrist
402
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46036358113
—
NE
05
—
9200817
—
SD
Enumeration date
07/25/2006
Last updated
08/29/2017
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