Healthcare Provider Details

I. General information

NPI: 1982775003
Provider Name (Legal Business Name): KATHRYN M LOWE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 06/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 W KAGY BLVD SUITE G
BOZEMAN MT
59715-6056
US

IV. Provider business mailing address

280 W KAGY BLVD SUITE G
BOZEMAN MT
59715-6056
US

V. Phone/Fax

Practice location:
  • Phone: 406-522-5437
  • Fax:
Mailing address:
  • Phone: 406-522-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number11817
License Number StateMT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: