Anderson, Earl
Anderson, Earl is an individual health care provider with primary practice located at 710 Riverside Dr , Waupaca WI 54981-1941. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Anderson, Earl can be contacted via phone (715) 258-1160.Contact Information
Primary practice address
710 Riverside Dr
Waupaca WI 54981-1941
Phone: (715) 258-1160
Fax: (715) 256-3079
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 26741 | Wisconsin |
Profile Details
| NPI number | 1942220058 |
|---|---|
| LBN Legal business name | Anderson, Earl |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2006 |
| Last updated | Nov 16th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942220058 | NPPES |
| Wisconsin | Other | 000169010 | MEDICARE PTAN |
| Wisconsin | MEDICAID | 30834600 | MEDICARE PTAN |
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