Provider Demographics
NPI:1386834950
Name:ANDERSON, JOSHUA DONALD (PA-C)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DONALD
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15530 E BRONCOS PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-7111
Mailing Address - Country:US
Mailing Address - Phone:720-851-2000
Mailing Address - Fax:720-851-2009
Practice Address - Street 1:15530 E BRONCOS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-7111
Practice Address - Country:US
Practice Address - Phone:720-851-2000
Practice Address - Fax:720-851-2009
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2011-10-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO97623318Medicaid
COCO300396Medicare PIN