Provider Demographics
NPI:1518058247
Name:ANDERSON, CURTIS R (OD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:R
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 MASSACHUSETTS ST
Mailing Address - Street 2:SUITE 302
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:SUITE 302
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1131-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS656840OtherFIRSTGUARD MEDICAID PLAN
KS100089780AMedicaid
KS651063OtherBLUE CROSS BLUE SHIELD KS
KSP00168294OtherRAILROAD MEDICARE
KST44086Medicare UPIN
KS0649550001Medicare NSC
KS656840OtherFIRSTGUARD MEDICAID PLAN