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DR. ROGER ALLAN ANDERSON OD

Eye and Vision Services Providers Optometrist

Provider NPI: 1740345776

Provider Information:
DR. ROGER ALLAN ANDERSON OD
Gender: M
Not Sole Proprietor

Practice Location:
1405 4TH ST SW WEST SIDE PROFESSIONAL CENTER STE 2 SIDNEY, MT 59270-3515 US
Tel: 406-488-2705  Fax: 406-488-2713

Business Mailing Address:
1405 4TH ST SW STE 2 SIDNEY, MT 59270-3515 US
Tel: 406-488-2705  Fax: 406-488-2713

NPI Information:
NPI: 1740345776
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
MT414

Other Provider Identifiers:

IssuerNumberStateType
0480857MT05
BLUE CROSS BLUE SHIELD27110MT01



American Medical Association 2012 taxonomy code information

Code: 152W00000X

Type:

Classification:



Definition:



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