Individual
JEROME D ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
525 E GRANT ST, MACOMB, IL 61455-3313
(309) 837-2368
(319) 233-0722
Mailing address
PO BOX 2660, WATERLOO, IA 50704-2660
(319) 233-3044
(319) 233-0722
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
03039
IA
207ZP0101X
Anatomic Pathology Physician
Primary
36075427
IL
Other
Enumeration date
01/05/2006
Last updated
07/30/2007
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