| Doctor Name: | TODD E. FOWLER |
| NPI Number: | 1164468674 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | |
| Business Practice Address: | 1724 Hamill Road Ste 102, Oasis Park Building I Hixson, TN - 373434905 |
| Business Phone Number: | 4232676738 |
| Business Fax Number: | 4232099106 |
| Mailing Address: | P.o. Box 669, HIXSON |
| State: | TN |
| Postal Code: | 373434905 |
| Phone Number: | 4232676738 |
| Fax Number: | 4232099106 |
| NPI Enumeration Date: | 06/22/2006 |
| NPI Last Update Date: | 12/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |