Fowler, Todd A

Fowler, Todd A is an individual health care provider with primary practice located at 2410 Susannah St , Johnson City TN 37601-1748. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Fowler, Todd A can be contacted via phone (423) 282-9011.

Contact Information

Primary practice address
2410 Susannah St Johnson City TN 37601-1748
Phone: (423) 282-9011
Fax: (423) 282-0035
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 24265 Tennessee

Profile Details

NPI number 1154386886
LBN Legal business name Fowler, Todd A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Dec 16th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154386886 NPPES
Tennessee MEDICAID 3075096

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