Healthcare Provider Details

I. General information

NPI: 1205890696
Provider Name (Legal Business Name): YVONNE RENEE LOWNE-CHASE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 W WENDOVER AVE
JAMESTOWN NC
27282-8300
US

IV. Provider business mailing address

PO BOX 405633
ATLANTA GA
30384-5633
US

V. Phone/Fax

Practice location:
  • Phone: 336-547-8422
  • Fax:
Mailing address:
  • Phone: 888-563-3282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9900590
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: