Anderson, Jack

Anderson, Jack is an individual health care provider with primary practice located at 9787 N 91St St Ste 101 , Scottsdale AZ 85258-5088. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Anderson, Jack can be contacted via phone (480) 563-6400.

Contact Information

Primary practice address
9787 N 91St St Ste 101 Scottsdale AZ 85258-5088
Phone: (480) 563-6400
Fax: (480) 563-8009
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 24265 Oklahoma
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 45727 Arizona

Profile Details

NPI number 1659338887
LBN Legal business name Anderson, Jack
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Dec 5th, 2012 - about 12 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 1659338887 NPPES
Oklahoma MEDICAID 200055660A

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