Andersen, Kenneth M

Andersen, Kenneth M is an individual health care provider with primary practice located at 5615 Nw 86Th St , Johnston IA 50131-1738. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Andersen, Kenneth M can be contacted via phone (515) 643-6000.

Contact Information

Primary practice address
5615 Nw 86Th St Johnston IA 50131-1738
Phone: (515) 643-6000
Fax: (515) 643-6001
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 24339 Iowa

Profile Details

NPI number 1386654986
LBN Legal business name Andersen, Kenneth M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2006
Last updated Jan 21st, 2024 - about 2 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 1386654986 NPPES
Iowa MEDICAID 3020362

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