Provider Demographics
NPI:1922338359
Name:DR. DAVID J. ANDERSON & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:DR. DAVID J. ANDERSON & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:602-234-2221
Mailing Address - Street 1:1831 E CAMELBACK RD
Mailing Address - Street 2:STE B2
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4162
Mailing Address - Country:US
Mailing Address - Phone:602-234-2221
Mailing Address - Fax:602-234-0074
Practice Address - Street 1:1831 E CAMELBACK RD
Practice Address - Street 2:STE B2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4162
Practice Address - Country:US
Practice Address - Phone:602-234-2221
Practice Address - Fax:602-234-0074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0822152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty