Brian L Anderson, DC
Individual provider Active NPI Neurology Chiropractor · Oshkosh, WI
NPI 1023050994 · NPPES record last updated Oct 3, 2007
Key facts
- NPI
- 1023050994
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Chiropractor 111NN0400X
- License
- 2355012 (WI)
- Practice address
- 420 S Koeller St
Ste 345
Oshkosh, WI 54902-5593 - Phone
- (920) 235-7373
- Fax
- (920) 235-7713
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2355012 | WI | MD | Neurology Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | 2355012 | WI | Yes |
Addresses
Primary practice location
420 S Koeller St
Ste 345
Oshkosh, WI 54902-5593
Mailing address
420 S Koeller St
Ste 345
Oshkosh, WI 54902-5593
Phone (920) 235-7373
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38842700 | Medicaid | WI |
Other providers in Oshkosh, WI
- Evelyn Lauren Andersen
- Anderson Chiropractic of Oshkosh, S. C.
- Anderson Vision Center, LTD.
- Amanda Clare Anderson
- Autumn Bridget Anderson
- Jaxson Reed Anderson
- John T Anderson
- Matthew S Anderson
- Sheila M Anderson
- Jeffrey P Andreini
All providers in Oshkosh, WI · Neurology Chiropractor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.