Provider Demographics
NPI:1316908700
Name:ANDRESEN, ALAN J (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:J
Last Name:ANDRESEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3333 E CAMELBACK RD
Mailing Address - Street 2:STE 122
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2323
Mailing Address - Country:US
Mailing Address - Phone:602-522-1900
Mailing Address - Fax:602-381-3281
Practice Address - Street 1:451 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2000
Practice Address - Country:US
Practice Address - Phone:480-965-3346
Practice Address - Fax:480-965-8914
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2018-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ19454207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine