Provider Demographics
NPI:1003950205
Name:FLOWERS, DUSTIN J (DPT)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:J
Last Name:FLOWERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOHENWALD
Mailing Address - State:TN
Mailing Address - Zip Code:38462-1355
Mailing Address - Country:US
Mailing Address - Phone:931-381-1111
Mailing Address - Fax:931-380-4108
Practice Address - Street 1:617 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HOHENWALD
Practice Address - State:TN
Practice Address - Zip Code:38462-1355
Practice Address - Country:US
Practice Address - Phone:931-381-1111
Practice Address - Fax:931-380-4108
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004920208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000004920OtherOPERATING LICENSE