MEDICARE: TROY ANDREW HIXSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	42625	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1335818	OTHER		CIGNA
2	621763648	OTHER		TAX ID

General Provider Information

NPI Number	:	1730382458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY ANDREW HIXSON MD

Provider Business Mailing Address
First Line	:	83 MEMORIAL DR
Second Line	:
City	:	WINCHESTER
State	:	TN
Zip	:	37398-2401
Country	:	US
Telephone Number	:	931-967-3966
Fax Number	:	931-962-0373

Provider Business Practice Location Address
First Line	:	83 MEMORIAL DR
Second Line	:
City	:	WINCHESTER
State	:	TN
Zip	:	37398-2401
Country	:	US
Telephone Number	:	931-967-3966
Fax Number	:	931-962-0373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	02/15/2012

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