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General NPI Number Information
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NPI Number | 1174963615
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Entity Type | Individual
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Provider Name | ANDREW DOUGLAS LINKOUS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2104 E ANDREW JOHNSON HWY
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City | MORRISTOWN
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State | TN
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Zip | 37814-5412
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Country | US
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Telephone | 423-438-0692
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Fax |
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Provider Business Mailing Address
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Address Line | 834 BOWEN CIR
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City | MEMPHIS
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State | TN
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Zip | 38122-3401
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Country | US
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Telephone | 423-839-3309
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9713
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License Number State | TN
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