MEDICARE: DR. ANDREW JAMES MACLELLAN 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	207X00000X	Orthopaedic Surgery Physician	MD38368	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00199559	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4083589	OTHER	TN	BLUE CROSS BLUE SHIELD
3	TN01J7	OTHER	TN	JOHN DEERE HEALTHCARE

General Provider Information

NPI Number	:	1992774665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW JAMES MACLELLAN M.D.

Provider Business Mailing Address
First Line	:	260 FORT SANDERS WEST BLVD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3355
Country	:	US
Telephone Number	:	865-769-4545
Fax Number	:	865-769-4501

Provider Business Practice Location Address
First Line	:	460 MEDICAL PARK DR
Second Line	:	SUITE 104
City	:	LENOIR CITY
State	:	TN
Zip	:	37772-5782
Country	:	US
Telephone Number	:	865-986-7737
Fax Number	:	865-986-7807

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

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	05/17/2011

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Directions to “ DR. ANDREW JAMES MACLELLAN M.D.” Practice Location

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