Individual provider · NPI-1

Ethan Scott Anderson, DO

Hospitalist · Columbia, MO

NPI number1104455732
StatusActive
Last updated in NPPESOct 8, 2025

Details

NPI
1104455732
Entity type
Individual (NPI-1)
Name
Ethan Scott Anderson
Credential
DO
Sex
Male
Sole proprietor
No
Enumeration date
Apr 6, 2020
Certification date
Oct 8, 2025
Last updated
Oct 8, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208M00000X Hospitalist2023011711MOYes
207R00000X Internal Medicine2023011711MO

Practice location

1 Hospital Dr
Columbia, MO 65212-0001

Phone 573-884-9066 · Fax 573-884-3037

Mailing address

Po Box 843966
Kansas City, MO 64184-3966

Phone 573-884-3300 · Fax 573-884-0943

Other practice locations

1125 N College Ave # Slot100
Fayetteville, AR 72703-1908

Phone 479-713-8700 · Fax 479-714-8670

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