MEDICARE: DR. BRIAN DAVID ROGERS 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	1968DT	KY
2	152W00000X	Optometrist	3213	TN

General Provider Information

NPI Number	:	1598174468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN DAVID ROGERS OD

Provider Business Mailing Address
First Line	:	1011 GALLATIN AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37206-3231
Country	:	US
Telephone Number	:	615-988-5356
Fax Number	:	615-649-5426

Provider Business Practice Location Address
First Line	:	1011 GALLATIN AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37206-3231
Country	:	US
Telephone Number	:	615-988-5356
Fax Number	:	615-649-5426

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

Provider Enumeration Date	:	08/05/2014
Last Update Date	:	05/20/2024

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