Individual
JOHN C. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10101 SE MAIN ST, SUITE 3008, PORTLAND, OR 97216-2455
(503) 489-1122
(503) 489-1123
Mailing address
5006 UNIVERSITY DRIVE, #3, COLLEGEDALE, TN 37315-5001
(503) 489-1122
(503) 489-1123
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
10506
SD
207X00000X
Orthopaedic Surgery Physician
C143100
CA
207X00000X
Orthopaedic Surgery Physician
MD26880
OR
207X00000X
Orthopaedic Surgery Physician
MD450150
PA
207X00000X
Orthopaedic Surgery Physician
S0422
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD26880
OR
Other
Enumeration date
07/21/2006
Last updated
09/24/2020
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