Provider Demographics
NPI:1821075904
Name:ANDERSON, JAMES A JR (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:ANDERSON
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 W CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-2137
Mailing Address - Country:US
Mailing Address - Phone:508-528-2525
Mailing Address - Fax:508-520-8901
Practice Address - Street 1:184 W CENTRAL ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-2137
Practice Address - Country:US
Practice Address - Phone:508-528-2525
Practice Address - Fax:508-520-8901
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2080213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA797930OtherTUFTS HEALTH PLAN
MA2425534OtherAETNA
MACIGNAOther2873617
MA0310735Medicaid
MA333304OtherHARVARD PILGRIM
MAY71031OtherBCBS MA
MA27-00477OtherEVERCARE
MAY71031OtherBCBS MA
U66374Medicare UPIN