Provider Demographics
NPI:1154316321
Name:TERRY, ANDREW POPE (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:POPE
Last Name:TERRY
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 1:2880 DAUPHIN ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-2457
Mailing Address - Country:US
Mailing Address - Phone:251-473-1900
Mailing Address - Fax:251-470-8943
Practice Address - Street 1:3701 DAUPHIN ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1756
Practice Address - Country:US
Practice Address - Phone:251-341-3368
Practice Address - Fax:251-341-3371
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11622207WX0110X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000034531Medicaid
AL51034531OtherBLUE CROSS PROVIDER #
ALB64295OtherHEALTHSPRING PROVIDER #
AL0810149OtherUNITED HEALTHCARE PROV. #
AL4113072OtherAETNA PROVIDER #