Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 3864 | CO |
Y | 213ER0200X | Radiology | 3864 | CO |
NPI | 1558482398 |
---|---|
Provider Name | Dr. William D Anderson |
First Address | Woodland Park, CO 80863-9528 |
Second Address | Colorado Springs, CO 80904-4023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/07/2007 |