Provider Demographics
NPI:1881145654
Name:RODEN, ANDREW (PA-C)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:RODEN
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:1067 RIVERFRONT PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-2195
Practice Address - Country:US
Practice Address - Phone:423-531-9300
Practice Address - Fax:423-531-9301
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2023-10-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN3150363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant