Individual
DR. BRYAN G ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
510 LINCOLN DRIVE, HERRIN, IL 62948
(618) 997-6800
(618) 997-1187
Mailing address
510 LINCOLN DRIVE, HERRIN, IL 62948
(618) 997-6800
(618) 997-1187
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
361168134
IL
207X00000X
Orthopaedic Surgery Physician
OP61396249
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2254675
—
WA
Enumeration date
06/10/2013
Last updated
12/10/2024
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