Provider Demographics
NPI:1891061396
Name:ANZELJC, ANDREW JAMES (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JAMES
Last Name:ANZELJC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4528 CHAPMAN HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-4359
Mailing Address - Country:US
Mailing Address - Phone:865-579-3920
Mailing Address - Fax:865-579-3918
Practice Address - Street 1:4528 CHAPMAN HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-4359
Practice Address - Country:US
Practice Address - Phone:865-579-3920
Practice Address - Fax:865-579-3963
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA75488207W00000X
TN57004207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology