Basic Information
| Provider Information | |||||||||
| NPI: | 1750581559 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDERS | ||||||||
| FirstName: | JUDD | ||||||||
| MiddleName: | EMERY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2345 E PRATER WAY STE 207 | ||||||||
| Address2: | |||||||||
| City: | SPARKS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894349634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753525301 | ||||||||
| FaxNumber: | 7753525303 | ||||||||
| Practice Location | |||||||||
| Address1: | 2375 E PRATER WAY | ||||||||
| Address2: | |||||||||
| City: | SPARKS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894349641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753525301 | ||||||||
| FaxNumber: | 7753525303 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2007 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 13557 | NV | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A110377 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | 13557 | NV | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.