Provider Demographics
NPI:1659309029
Name:ANDREWS, JAMES E JR (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:ANDREWS
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 17TH AVE E STE 101
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-5274
Mailing Address - Country:US
Mailing Address - Phone:320-762-1144
Mailing Address - Fax:320-762-1935
Practice Address - Street 1:111 17TH AVE E STE 101
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-5274
Practice Address - Country:US
Practice Address - Phone:320-762-1144
Practice Address - Fax:320-762-1935
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN45317208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNBA6419495OtherDEA
MNBA6419495OtherDEA
MNG52362Medicare UPIN
NE41091744413Medicaid
MN250000573Medicare ID - Type UnspecifiedJEA MEDICARE #
MN410917444OtherJEA-ONE HEALTH PLAN
MNHP37216OtherJEA HEALTHPARTNERS #
MN1033131OtherJEA PREFERRED ONE #
MNG52362Medicare UPIN
MN201957400Medicaid
ND10344Medicaid
MN171285OtherJEA UCARE #