Dr. Douglas Ken Andersen, DO
Internal Medicine in Pocatello, ID. Individual provider (NPI-1).
NPI number1730599598
StatusActive
Last updated in NPPESOct 27, 2022
Details
- NPI
- 1730599598
- Entity type
- Individual (NPI-1)
- Name
- Dr. Douglas Ken Andersen
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 2, 2014
- Certification date
- Oct 27, 2022
- Last updated
- Oct 27, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 6352 | OK | Yes |
Practice location
777 Hospital WayPocatello, ID 83201-5175
Phone 208-239-1720 · Fax 208-239-1726
Mailing address
10109 E. 79th StreetTulsa, OK 74133
Phone 918-286-5000 · Fax 918-249-7514
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