Individual
CAROL L ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5161 PLEASANT AVE, FAIRFIELD, OH 45014-2639
(513) 896-1578
(513) 896-1687
Mailing address
5161 PLEASANT AVE, FAIRFIELD, OH 45014-2639
(513) 896-1578
(513) 896-1687
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
325-051202
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000014329
ANTHEM
—
05
—
0675443
—
OH
05
—
31192739026
—
OH
Enumeration date
11/22/2006
Last updated
12/15/2011
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