| Dr Timothy John Anderson, MD | |
|
501 E Nicollet Blvd, Suite 200, Burnsville, MN 55337-6732 | |
| (952) 898-5900 | |
| (952) 898-5914 |
| Full Name | Dr Timothy John Anderson |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 501 E Nicollet Blvd, Burnsville, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245243138 | NPI | - | NPPES |
| 416282000 | Medicaid | MN | |
| FP9020802010 | Other | MN | PREFERRED ONE |
| 13183AN | Other | MN | BC/BS |
| 1211637 | Other | MN | MEDICA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 30239 (Minnesota) | Primary |
| Entity Name | Southdale Pediatric Associates Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245305895 PECOS PAC ID: 4981597077 Enrollment ID: O20040203000879 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Timothy John Anderson, MD 3955 Parklawn Ave, Suite 120, Edina, MN 55435-5655 Ph: (952) 831-1944 | Dr Timothy John Anderson, MD 501 E Nicollet Blvd, Suite 200, Burnsville, MN 55337-6732 Ph: (952) 898-5900 |
Dr. Allison Schneider Freese, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 303 E Nicollet Blvd, Burnsville, MN 55337 Phone: 319-721-9499 | |
Dr. Sheila J Jenkins, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 14000 Fairview Dr, Burnsville, MN 55337 Phone: 952-993-8700 | |
Kristine A Foslien, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 303 Nicollet Blvd, Burnsville, MN 55337 Phone: 952-892-8770 | |
Dr. Lisa Wilkinson Oie, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 501 E Nicollet Blvd, Ste 200, Burnsville, MN 55337 Phone: 952-831-1944 Fax: 952-278-6947 | |
Brielle Joy Swanstrom, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 14000 Fairview Dr, Burnsville, MN 55337 Phone: 952-993-8700 Fax: 952-993-8516 | |
Mrs. Gillian Hackedorn Luscri, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 14000 Fairview Dr, Burnsville, MN 55337 Phone: 952-993-8682 |