Individual
ERIC ARTHUR ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
47 DOC PERKES RD, AFTON, WY 83110-7703
(307) 885-3637
(307) 885-3638
Mailing address
740 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(208) 542-9111
(208) 542-9114
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.60410145
WA
363AM0700X
Medical Physician Assistant
PA60410145
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT890
STATE
WY
Enumeration date
08/29/2013
Last updated
10/14/2020
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