Provider Demographics
NPI:1417048141
Name:CURTIS R. ANDERSON, O.D.
Entity Type:Organization
Organization Name:CURTIS R. ANDERSON, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:785-843-8200
Mailing Address - Street 1:932 MASSACHUSETTS ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2868
Mailing Address - Country:US
Mailing Address - Phone:785-843-8200
Mailing Address - Fax:785-843-8262
Practice Address - Street 1:932 MASSACHUSETTS ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2868
Practice Address - Country:US
Practice Address - Phone:785-843-8200
Practice Address - Fax:785-843-8262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSDD7105OtherRAILROAD MEDICARE
KS065117OtherBLUECROSSBLUESHIELDKS
KS065117OtherBLUECROSSBLUESHIELDKS
KS0649550001Medicare NSC