Provider Demographics
NPI:1518901859
Name:TEMME, BRIAN D (OD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:TEMME
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 4TH AVE
Mailing Address - Street 2:P.O. BOX 160
Mailing Address - City:WINDOM
Mailing Address - State:MN
Mailing Address - Zip Code:56101-1440
Mailing Address - Country:US
Mailing Address - Phone:507-831-2429
Mailing Address - Fax:507-831-4243
Practice Address - Street 1:1006 4TH AVE
Practice Address - Street 2:
Practice Address - City:WINDOM
Practice Address - State:MN
Practice Address - Zip Code:56101-1440
Practice Address - Country:US
Practice Address - Phone:507-831-2429
Practice Address - Fax:507-831-4243
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2062152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN958523100Medicaid
MN958523100Medicaid
T66202Medicare UPIN