Anson Lamar Anderson, HIS

Individual provider Active NPI Hearing Instrument Specialist · Madison, WV

NPI 1134486301 · NPPES record last updated Mar 24, 2021

Key facts

NPI
1134486301
Entity type
Individual (NPI type 1)
Primary specialty
Hearing Instrument Specialist 237700000X
License
886 (WV)
Practice address
167 State St
Madison, WV 25130-1139
Phone
(304) 369-1123
Fax
(304) 369-9001
NPI assigned
Apr 12, 2012
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)
No

State licenses

LicenseStateTypeSpecialty
886WVMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 886 WV Yes

Addresses

Primary practice location

167 State St
Madison, WV 25130-1139

Mailing address

750 N Commons Dr Ste 200
Aurora, IL 60504-7940
Phone (630) 303-5380

Other providers in Madison, WV

All providers in Madison, WV · Hearing Instrument Specialist in West Virginia

Sources for this page

Verify at the official NPI Registry.