Individual
ANDREW LEVI BLYTHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2103 FOREST DR STE 5, GRAY, TN 37615-8423
(423) 794-3142
(423) 794-3184
Mailing address
1326 PAPERMILL POINTE WAY, KNOXVILLE, TN 37909-1903
(865) 243-2136
(865) 243-2138
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3961
MEDICAL LICENSE
TN
Enumeration date
12/09/2019
Last updated
05/13/2024
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