DR. PHILIP GORDON ANDRE MD NPI 1619972338

NPI Information

  • NPI: 1619972338
  • Provider Name: DR. PHILIP GORDON ANDRE, MD
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • Address: 11180 HWY 51 N.
    STE 3
    ATOKA, TN
    ZIP 38004
  • Phone: (901) 837-9910

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NPI Details

DR. Philip Gordon Andre, MD is a specialist in Atoka, TN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Philip Gordon Andre, MD NPI is 1619972338. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11180 HWY 51 N.
STE 3
ATOKA, TN
ZIP 38004
Phone: (901) 837-9910
Fax: (901) 837-9914

The enumeration date for this NPI number is 6/17/2005 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist39028TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13325236MEDICARE ID-TYPE UNSPECIFIEDTENNESSEEMEDICARE #
2D54927MEDICARE UPINTENNESSEE
33717404MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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