Provider Demographics
NPI:1558534909
Name:TODD, WILLIAM ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ANDREW
Last Name:TODD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8401 HIGHWAY 111
Mailing Address - Street 2:
Mailing Address - City:BYRDSTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38549-6031
Mailing Address - Country:US
Mailing Address - Phone:931-864-3187
Mailing Address - Fax:
Practice Address - Street 1:8401 HIGHWAY 111
Practice Address - Street 2:
Practice Address - City:BYRDSTOWN
Practice Address - State:TN
Practice Address - Zip Code:38549
Practice Address - Country:US
Practice Address - Phone:931-864-3187
Practice Address - Fax:931-864-7102
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2455207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1531649Medicaid
TN103I110461Medicare PIN