Individual
DR. JEFFREY B ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
602 LEGION DR, MONTEVIDEO, MN 56265-1709
(320) 269-8182
(320) 269-5868
Mailing address
PO BOX 188, MONTEVIDEO, MN 56265-0188
(320) 269-8182
(320) 269-5868
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1614
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2214650
MEDICA
—
05
—
334723100
—
MN
01
—
419000354
HUMANA
—
01
—
44020AN
BLUE CROSS AND BLUE SHIEL
MN
01
—
5C004AN
BCBS OPTICAL ONLY
MN
01
—
715581024800
PREFERRED ONE
MN
01
—
HP21877
HEALTH PARTNERS
—
Enumeration date
10/03/2005
Last updated
12/29/2011
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