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Individual

DR. ANDREW MARTIN DOUGLASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1344 DOWELL SPRINGS BLVD, KNOXVILLE, TN 37909-2453
(865) 686-0507
(865) 357-8346
Mailing address
PO BOX 52333, KNOXVILLE, TN 37950-2333
(865) 686-0507
(865) 357-8346

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
021979
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00171113
MEDICARE RAILROAD
TN
Enumeration date
11/09/2005
Last updated
09/27/2011
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