Individual
JEFFREY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., FAEP
Contact information
Practice address
1007 LINCOLNWAY, LA PORTE, IN 46350-3201
(219) 326-1234
Mailing address
75 REMIT DR NO 3309, CHICAGO, IL 60675-3309
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01037772A
IN
207P00000X
Emergency Medicine Physician
—
IL
Other
Enumeration date
07/14/2006
Last updated
02/19/2008
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