Provider Demographics
NPI:1598174468
Name:ROGERS, BRIAN DAVID (OD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DAVID
Last Name:ROGERS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1011 GALLATIN AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3231
Mailing Address - Country:US
Mailing Address - Phone:615-988-5356
Mailing Address - Fax:615-649-5426
Practice Address - Street 1:1011 GALLATIN AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3231
Practice Address - Country:US
Practice Address - Phone:615-988-5356
Practice Address - Fax:615-649-5426
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1968DT152W00000X
TN3213152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist