1750490512 NPI number — DR. ERNEST B LOWE JR. M.D.

Table of content: DR. ERNEST B LOWE JR. M.D. (NPI 1750490512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750490512 NPI number — DR. ERNEST B LOWE JR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOWE
Provider First Name:
ERNEST
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1750490512
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:
2200 S LAMAR BLVD
Provider Second Line Business Mailing Address:
SUITE F
Provider Business Mailing Address City Name:
OXFORD
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38655
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-234-4446
Provider Business Mailing Address Fax Number:
662-234-2961

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 S LAMAR BLVD
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
OXFORD
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-234-4446
Provider Business Practice Location Address Fax Number:
662-234-2961
Provider Enumeration Date:
08/29/2006

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: 207X00000X , with the licence number:  12255 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207XX0005X , with the licence number: 12255 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 00011021 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com