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Individual

DR. BRIAN T FOWLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1068 CRESTHAVEN RD STE 400, MEMPHIS, TN 38119-0845
(901) 448-6650
(901) 302-2486
Mailing address
1068 CRESTHAVEN RD STE 300, MEMPHIS, TN 38119-0809
(901) 866-8864

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
48454
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003181478A
GA
05
005372219
MS
05
1093987893
MO
05
1528624
TN
05
182749
AL
05
193108001
AR
Enumeration date
04/01/2008
Last updated
02/21/2025
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