Provider Demographics
NPI:1811028616
Name:ANDERSON, TONYA KAY (MD)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:KAY
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:KAY
Other - Last Name:LUNDQUIST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1010 THREE SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-8296
Mailing Address - Country:US
Mailing Address - Phone:970-247-4311
Mailing Address - Fax:970-764-3789
Practice Address - Street 1:1010 THREE SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-8296
Practice Address - Country:US
Practice Address - Phone:970-764-3352
Practice Address - Fax:970-764-3375
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43440207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
016396OtherKAISER-COMMERCIAL NUMBER
CO73084719Medicaid
COC802744Medicare PIN
COI38394Medicare UPIN