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Individual

ANDREW W CROTHERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
825 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9411
(901) 685-2200
(901) 820-2342
Mailing address
825 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9411
(901) 685-2200
(901) 820-2342

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
22308
MS
207W00000X
Ophthalmology Physician
Primary
49228
TN
207W00000X
Ophthalmology Physician
E-7739
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08605892
MS
05
1530817
TN
05
1952500373
MO
05
202151001
AR
Enumeration date
07/16/2007
Last updated
01/09/2018
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