MEDICARE: TODD E. 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	207Y00000X	Otolaryngology Physician	MD29755	TN

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	:	1164468674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD E. FOWLER M.D.

Provider Business Mailing Address
First Line	:	3024 BUSINESS PARK CIR
Second Line	:
City	:	GOODLETTSVILLE
State	:	TN
Zip	:	37072-3132
Country	:	US
Telephone Number	:	615-239-2018
Fax Number	:	615-851-2018

Provider Business Practice Location Address
First Line	:	1724 HAMILL RD STE 102
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-5098
Country	:	US
Telephone Number	:	423-267-6738
Fax Number	:	423-635-7544

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	11/06/2025

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