MEDICARE: FUSUN OZLEN GOKMEN FOWLER 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	255052	MA

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

General Provider Information

NPI Number	:	1134368517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FUSUN OZLEN GOKMEN FOWLER M.D.

Provider Business Mailing Address
First Line	:	51 STATE RD
Second Line	:
City	:	DARTMOUTH
State	:	MA
Zip	:	02747-3319
Country	:	US
Telephone Number	:	508-994-1400
Fax Number	:	508-910-2212

Provider Business Practice Location Address
First Line	:	8120 TIMBERLAKE WAY STE 211
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-5414
Country	:	US
Telephone Number	:	916-423-2134
Fax Number	:	916-423-4477

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

Provider Enumeration Date	:	02/09/2009
Last Update Date	:	08/02/2022

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