Healthcare Provider Details

I. General information

NPI: 1669588802
Provider Name (Legal Business Name): JASON ALLEN LOWE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 N ALVERNON WAY STE 205
TUCSON AZ
85711-1847
US

IV. Provider business mailing address

ORTHOPAEDIC SURGERY 1501 N CAMPBELL AVE, ROOM# 8401
TUCSON AZ
85724-5064
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8000
  • Fax: 520-694-8005
Mailing address:
  • Phone: 520-626-4024
  • Fax: 520-626-2668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number30252
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberT2004017096
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number52122
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: