=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376752980
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRYAN TOLE FISHER SR. MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2007
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 353 NEW SHACKLE ISLAND RD STE 102A
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37075-2359
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-500-7336
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 410 42ND AVE N STE 400
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37209-3658
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-329-7887
-----------------------------------------------------
Fax | 615-346-6225
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number | MD46725
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | MD46725
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------