Provider Demographics
NPI: | 1588691083 |
---|---|
Name: | THOMSON, ANDREW BRIAN (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | ANDREW |
Middle Name: | BRIAN |
Last Name: | THOMSON |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2021 CHURCH ST |
Mailing Address - Street 2: | SUITE 200 |
Mailing Address - City: | NASHVILLE |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37203-2021 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 615-324-1600 |
Mailing Address - Fax: | 615-284-2003 |
Practice Address - Street 1: | 2021 CHURCH ST |
Practice Address - Street 2: | SUITE 200 |
Practice Address - City: | NASHVILLE |
Practice Address - State: | TN |
Practice Address - Zip Code: | 37203-2021 |
Practice Address - Country: | US |
Practice Address - Phone: | 615-324-1600 |
Practice Address - Fax: | 615-284-2003 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-06-28 |
Last Update Date: | 2015-10-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TN | MD38317 | 207XX0004X, 207XS0114X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207XS0114X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery |
No | 207XX0004X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
I37265 | Medicare UPIN |