Provider Demographics
NPI:1184880304
Name:ANDERSON, JAMES DREW (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DREW
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N HURSTBOURNE PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5360
Mailing Address - Country:US
Mailing Address - Phone:502-423-0500
Mailing Address - Fax:502-423-0719
Practice Address - Street 1:410 N HURSTBOURNE PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5360
Practice Address - Country:US
Practice Address - Phone:502-423-0500
Practice Address - Fax:502-423-0719
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY249528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor