1194795195 NPI number — JAMIE B LOWE MD

Table of content: JAMIE B LOWE MD (NPI 1194795195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194795195 NPI number — JAMIE B LOWE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOWE
Provider First Name:
JAMIE
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194795195
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2241
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENWOOD SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81602-2241
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-945-1443
Provider Business Mailing Address Fax Number:
970-947-9410

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1830 BLAKE AVE
Provider Second Line Business Practice Location Address:
#206
Provider Business Practice Location Address City Name:
GLENWOOD SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-928-0808
Provider Business Practice Location Address Fax Number:
970-928-7591
Provider Enumeration Date:
01/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  41870 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00074337 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: L0669968 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 89387210 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".