MEDICARE: ANTHONY B. LOWE, O.D., P.L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1019-OD	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770731796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHONY B. LOWE, O.D., P.L.L.C.

Provider Business Mailing Address
First Line	:	200 QUARRIER ST
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25301-2006
Country	:	US
Telephone Number	:	304-206-8354
Fax Number	:

Provider Business Practice Location Address
First Line	:	4008 MACCORKLE AVE SW
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25309-1510
Country	:	US
Telephone Number	:	304-206-8354
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANTHONY B. LOWE
Credential	:	O.D.
Telephone Number	:	304-206-8354

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	10/27/2008

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