Provider Demographics
NPI:1699930008
Name:ROBERT L. ANDERSON, M.D., P.C.
Entity type:Organization
Organization Name:ROBERT L. ANDERSON, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-463-3634
Mailing Address - Street 1:2115 N KANSAS AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-2615
Mailing Address - Country:US
Mailing Address - Phone:402-463-3634
Mailing Address - Fax:402-463-0033
Practice Address - Street 1:2115 N KANSAS AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-2615
Practice Address - Country:US
Practice Address - Phone:402-463-3634
Practice Address - Fax:402-463-0033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15995208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty