Provider Demographics
NPI:1831124353
Name:FLOWERS, TOM KEVIN (OD)
Entity Type:Individual
Prefix:DR
First Name:TOM
Middle Name:KEVIN
Last Name:FLOWERS
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 1:189 W UNIVERSITY PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1671
Mailing Address - Country:US
Mailing Address - Phone:731-664-9600
Mailing Address - Fax:731-664-0808
Practice Address - Street 1:189 W UNIVERSITY PKWY STE D
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1671
Practice Address - Country:US
Practice Address - Phone:731-664-9600
Practice Address - Fax:731-664-0808
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD-T1462152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN410034659OtherRAILROAD MEDICARE
TN3598797Medicaid
TN3077252OtherBCBS TN PROVIDER NUMBER
TN02628OtherSPECTERA PROVIDER NUMBER
TN410034659OtherRAILROAD MEDICARE
TN1216830001Medicare NSC
TNU43068Medicare UPIN