Andersen, Colby J

Andersen, Colby J is an individual health care provider with primary practice located at 550 E 1400 N , Logan UT 84341-2406. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Andersen, Colby J can be contacted via phone (435) 752-7060.

Contact Information

Primary practice address
550 E 1400 N Logan UT 84341-2406
Phone: (435) 752-7060
Fax: (801) 394-4609
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1078 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA3028 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10912261-1206 Utah

Profile Details

NPI number 1124330865
LBN Legal business name Andersen, Colby J
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2010
Last updated Jul 10th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124330865 NPPES
Colorado MEDICAID 35933330

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