Healthcare Provider Details

I. General information

NPI: 1023126653
Provider Name (Legal Business Name): ANDREW DOUGLAS MEFFORD DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5780 AIRLINE RD SUITE101
ARLINGTON TN
38002-4264
US

IV. Provider business mailing address

2705 APPLING RD SUITE 101
MEMPHIS TN
38133-5082
US

V. Phone/Fax

Practice location:
  • Phone: 901-867-5657
  • Fax: 901-867-5202
Mailing address:
  • Phone: 901-388-9110
  • Fax: 901-384-7662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8358
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: