Basic Information
| Provider Information | |||||||||
| NPI: | 1740207760 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOWNSEND | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3889 | ||||||||
| Address2: | |||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376023889 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237942457 | ||||||||
| FaxNumber: | 4232839480 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 MED TECH PKWY STE 180 | ||||||||
| Address2: | |||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376042651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237945540 | ||||||||
| FaxNumber: | 4239263187 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2006 | ||||||||
| LastUpdateDate: | 11/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD28174 | TN | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 753041010 | 01 | CORVEL | OTHER | 753041010 | 01 | PHCS | OTHER | 1240931 | 01 | UNITED HEALTHCARE | OTHER | 4051821 | 01 | USA | OTHER | 4146624 | 01 | TN | BCBST | OTHER | 753041010 | 01 | CHOICE CARE | OTHER | 753041010 | 01 | CHAMPUS | OTHER | 753041010 | 01 | INITIAL GROUP | OTHER | 753041010 | 01 | ONE HEALTH | OTHER | 702023819 | 01 | PHP COMMERCIAL | OTHER | 100041325 | 01 | PHP TENNCARE | OTHER | 753041010 | 01 | FIRST HEALTH | OTHER | TN0105 | 01 | JOHN DEERE COMM | OTHER | 5059588 | 01 | AETNA | OTHER | 753041010 | 01 | BEECH STREET | OTHER | 3496644 | 05 | TN | MEDICAID | TN0105 | 01 | TENNCARE | OTHER |