Jeffrey B Anderson OD PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1614 Issued in MN

Legal business name

JEFFREY B ANDERSON OD PLLC

Practice address

602 Legion Dr
Montevideo, MN 56265-1709

Phone

(320) 269-8182

Fax

(320) 269-5868

NPI assigned

Dec 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lynette Norman

Title

Assistant

Phone

(320) 269-8182

Specialties & licenses 1

Addresses

Other names 1

• Jeffrey B Anderson OD Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1962684852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562650188",
            "telephone_number": "320-269-8182",
            "fax_number": "320-269-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 LEGION DR",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651709",
            "telephone_number": "320-269-8182",
            "fax_number": "320-269-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY B ANDERSON OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "NORMAN",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "ASSISTANT",
        "authorized_official_telephone_number": "320-269-8182",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffrey B Anderson OD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Montevideo, MN
• Providers in Montevideo, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.