Healthcare Provider Details

I. General information

NPI: 1588291819
Provider Name (Legal Business Name): ANDREW MASTERS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8635 MIDDLEBROOK PIKE
KNOXVILLE TN
37923-1612
US

IV. Provider business mailing address

1924 ALCOA HWY # U-67
KNOXVILLE TN
37920-1511
US

V. Phone/Fax

Practice location:
  • Phone: 865-824-0079
  • Fax: 833-908-2101
Mailing address:
  • Phone: 865-305-9350
  • Fax: 865-305-9353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4999
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: