MEDICARE: ANDREW GORDON MEADOR M.D.

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	207W00000X	Ophthalmology Physician	55515	TN
2	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	55515	TN

General Provider Information

NPI Number	:	1134462450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW GORDON MEADOR M.D.

Provider Business Mailing Address
First Line	:	UNIVERSITY OF TENNESSEE
Second Line	:	910 MADISON AVENUE SUITE 1031
City	:	MEMPHIS
State	:	TN
Zip	:	38163-0001
Country	:	US
Telephone Number	:	901-448-5364
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 CHURCH ST STE 100
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2233
Country	:	US
Telephone Number	:	615-329-3624
Fax Number	:

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

Provider Enumeration Date	:	04/04/2013
Last Update Date	:	03/22/2018

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