Individual
DR. JEFF BRUCE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1360 TOWN CENTRE DR, EAGAN, MN 55123
(651) 686-7435
Mailing address
116 KRESTWOOD DRIVE, BURNSVILLE, MN 55337
(952) 223-1270
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2956
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202818
MEDICA
MN
01
—
2202941
MEDICA
MN
01
—
2203374
MEDICA
MN
01
—
328M9AN
BLUE CROSS BLUE SHIELD
MN
01
—
979851041639
PERFERRED ONE
MN
Enumeration date
09/22/2006
Last updated
07/08/2007
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