MEDICARE: BRETT BOWERS OD

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	152W00000X	Optometrist	OPT.006871	OH

General Provider Information

NPI Number	:	1336761162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT BOWERS OD

Provider Business Mailing Address
First Line	:	PO BOX 45934
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21297-5934
Country	:	US
Telephone Number	:	614-228-4500
Fax Number	:	614-384-2966

Provider Business Practice Location Address
First Line	:	262 NEIL AVE STE 320
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-7311
Country	:	US
Telephone Number	:	614-228-4500
Fax Number	:	614-221-0138

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

Provider Enumeration Date	:	05/14/2020
Last Update Date	:	07/27/2021

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Directions to “ BRETT BOWERS OD” Practice Location

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