Allan L Andersen, MS
Individual provider Active NPI Audiologist · Sandy, UT
NPI 1194780783 · NPPES record last updated Dec 23, 2008
Key facts
- NPI
- 1194780783
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 1048354101 (UT)
- Practice address
- 9690 S 1300 E
Suite 200
Sandy, UT 84094-3721 - Phone
- (801) 501-4305
- Fax
- (801) 501-4308
- NPI assigned
- Apr 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1048354101 | UT | MD | Audiologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1048354101 | UT | Yes |
Addresses
Primary practice location
9690 S 1300 E
Suite 200
Sandy, UT 84094-3721
Mailing address
9690 S 1300 E
Suite 200
Sandy, UT 84094-3721
Phone (801) 501-4305
Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2008. 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.