Individual
JUSTIN DOUGLAS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4003 KRESGE WAY STE 115, LOUISVILLE, KY 40207-4652
(502) 897-8163
(502) 928-8919
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5499
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R76708
AZ
2085R0001X
Radiation Oncology Physician
Primary
TP508
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2018
Last updated
05/01/2023
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