Provider Demographics
NPI:1982854725
Name:ANDERSON, JAMES HARRY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HARRY
Last Name:ANDERSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12934 TREATY LINE ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8382
Mailing Address - Country:US
Mailing Address - Phone:317-848-5302
Mailing Address - Fax:317-848-5760
Practice Address - Street 1:12934 TREATY LINE ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8382
Practice Address - Country:US
Practice Address - Phone:317-848-5302
Practice Address - Fax:317-848-5760
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035151207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism