Healthcare Provider Details

I. General information

NPI: 1033286307
Provider Name (Legal Business Name): LOWERY H HUFF DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 0 WOODROW WILSON AVE
JACKSON MS
39216
US

IV. Provider business mailing address

500 0 WOODROW WILSON AVE
JACKSON MS
39216
US

V. Phone/Fax

Practice location:
  • Phone: 601-366-2661
  • Fax: 601-982-1740
Mailing address:
  • Phone: 601-366-2661
  • Fax: 601-982-1740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number80029
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: