Jack Raymond Anderson

NPI #1881166775 in Cleveland, Ohio

Provider Information

NPI Number: 1881166775
Entity Type: Individual
Name: Jack Raymond Anderson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Surgery
Enumeration Date: Dec 18, 2018
Last Updated: Dec 18, 2018

Practice Location

Address: 1730 W 25TH ST
City: Cleveland
State: Ohio
ZIP Code: 44113-3108
Phone: (216) 903-7287

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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