Provider Demographics
NPI:1477554095
Name:ANDERSON, DOUGLAS CALVIN JR (PHARMD, DPH)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:CALVIN
Last Name:ANDERSON
Suffix:JR
Gender:
Credentials:PHARMD, DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9702A 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OSCODA
Mailing Address - State:MI
Mailing Address - Zip Code:48750-1937
Mailing Address - Country:US
Mailing Address - Phone:937-668-4579
Mailing Address - Fax:815-425-7982
Practice Address - Street 1:OSCODA VA CLINIC
Practice Address - Street 2:5671 N SKEEL AVE
Practice Address - City:OSCODA TWP
Practice Address - State:MI
Practice Address - Zip Code:48750-1535
Practice Address - Country:US
Practice Address - Phone:989-497-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-04
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK108551835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist