Robert Anderton, MD
Individual provider Active NPI Dermatology Physician · Mesa, AZ
NPI 1659630713 · NPPES record last updated May 10, 2012
Key facts
- NPI
- 1659630713
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 6501 (AZ)
- Practice address
- 4318 N Desert Oasis Cir
Mesa, AZ 85207-7246 - Phone
- (480) 307-6929
- NPI assigned
- May 10, 2012
- 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)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6501 | AZ | MD | Dermatology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 6501 | AZ | Yes |
Addresses
Primary practice location
4318 N Desert Oasis Cir
Mesa, AZ 85207-7246
Mailing address
4318 N Desert Oasis Cir
Mesa, AZ 85207-7246
NPI Registry JSON
{
"created_epoch": "1336608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336608000000",
"number": "1659630713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4318 N DESERT OASIS CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852077246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4318 N DESERT OASIS CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852077246",
"telephone_number": "480-307-6929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERTON",
"first_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-10",
"last_updated": "2012-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "AZ",
"license": "6501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
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- Sandra Sue Anderson
- Weston Taylor Anderson
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- Omar Antonio Andino-Ortega
- Josseline Andrade Carrillo
- Andre C Matthews
- Christian Andreen
- Andrew T Weir, DDS, PC
All providers in Mesa, AZ · Dermatology Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2012. 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.