Individual
DR. PHILIP GORDON ANDRE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11180 HWY 51 N., STE 3, ATOKA, TN 38004
(901) 837-9910
(901) 837-9914
Mailing address
11180 HWY 51 N., STE 3, ATOKA, TN 38004
(901) 837-9910
(901) 837-9914
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
39028
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3717404
—
TN
Enumeration date
06/17/2005
Last updated
07/09/2007
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