Individual
EDWARD ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
411 LETCHER ST, HENDERSON, KY 42420-4245
(270) 830-6522
Mailing address
PO BOX 1593, HENDERSON, KY 42419-1593
(270) 830-6522
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0197
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100381580A
—
IN
01
—
480034923
RAILROAD MEDICARE
KY
05
—
80001977
—
KY
01
—
P00733506
RAILROAD MEDICARE
IN
Enumeration date
05/23/2005
Last updated
04/07/2017
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