Provider Demographics
NPI:1558339002
Name:MORGAN, ANDREW C (PA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:C
Last Name:MORGAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 OAK RIDGE TPKE
Mailing Address - Street 2:SUITE A300
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6957
Mailing Address - Country:US
Mailing Address - Phone:865-482-2129
Mailing Address - Fax:865-482-4036
Practice Address - Street 1:800 OAK RIDGE TPKE
Practice Address - Street 2:SUITE A300
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6957
Practice Address - Country:US
Practice Address - Phone:865-482-2129
Practice Address - Fax:865-482-4036
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000000865363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
0079196OtherBLUECROSS OF TENNESSEE ID
0079196OtherBLUECROSS OF TENNESSEE ID
TNS61804Medicare UPIN