Andre, Philip Gordon

Andre, Philip Gordon is an individual health care provider with primary practice located at 11180 Hwy 51 N. Ste 3, Atoka TN 38004. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Andre, Philip Gordon can be contacted via phone (901) 837-9910.

Contact Information

Primary practice address
11180 Hwy 51 N. Ste 3 Atoka TN 38004
Fax: (901) 837-9914
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 39028 Tennessee

Profile Details

NPI number 1619972338
LBN Legal business name Andre, Philip Gordon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619972338 NPPES
Tennessee MEDICAID 3717404

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