Individual
DR. JOHN ROGER ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8611 W EAGLE RIDGE RD, COEUR D ALENE, ID 83814-9565
(208) 664-4455
(208) 664-4159
Mailing address
8611 W EAGLE RIDGE RD, COEUR D ALENE, ID 83814-9565
(208) 664-4455
(208) 664-4159
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0102204169
VA
2085R0202X
Diagnostic Radiology Physician
Primary
O-0349
ID
Other
Enumeration date
05/05/2006
Last updated
08/04/2023
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