Individual
DR. JOHN SAMUEL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2255 SPRUCE GOOSE ST UNIT 649, LAS VEGAS, NV 89135-2649
(720) 891-8322
Mailing address
2255 SPRUCE GOOSE ST UNIT 649, LAS VEGAS, NV 89135-2649
(720) 891-8322
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2003014155
MO
2085R0202X
Diagnostic Radiology Physician
Primary
23583
NV
2085R0202X
Diagnostic Radiology Physician
47442
CO
2085R0202X
Diagnostic Radiology Physician
M-2209
GU
2085R0202X
Diagnostic Radiology Physician
MD30033
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020065
KAISER COMMERCIAL NUMBER
CO
05
—
1376607150
—
ME
05
—
65474091
—
CO
Enumeration date
12/19/2006
Last updated
01/08/2026
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