Provider Demographics
NPI:1083660880
Name:SMITH, ANDREW LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LOUIS
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1275 DICK LONAS RD
Mailing Address - Street 2:UNIT 101
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1383
Mailing Address - Country:US
Mailing Address - Phone:865-500-2144
Mailing Address - Fax:865-381-1509
Practice Address - Street 1:280 FORT SANDERS WEST BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3351
Practice Address - Country:US
Practice Address - Phone:865-539-0270
Practice Address - Fax:865-560-9209
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2020-06-17
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Provider Licenses
StateLicense IDTaxonomies
TN34640207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3867554Medicare ID - Type Unspecified
TNE15680Medicare UPIN