Healthcare Provider Details

I. General information

NPI: 1518454693
Provider Name (Legal Business Name): ANDREW THOMSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2018
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 BROADMOR BLVD SUITE 160
MURFREESBORO TN
37129
US

IV. Provider business mailing address

630 BROADMOR ST STE 160
MURFREESBORO TN
37129-0908
US

V. Phone/Fax

Practice location:
  • Phone: 615-455-1978
  • Fax: 615-281-6848
Mailing address:
  • Phone: 615-455-1978
  • Fax: 615-281-6848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number5212
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: