Healthcare Provider Details

I. General information

NPI: 1861882383
Provider Name (Legal Business Name): JAMES BENJAMIN LOWE III MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 NW EXPRESSWAY
OKLAHOMA CITY OK
73112-7163
US

IV. Provider business mailing address

2520 NW EXPRESSWAY
OKLAHOMA CITY OK
73112-7163
US

V. Phone/Fax

Practice location:
  • Phone: 405-286-9740
  • Fax: 405-753-5428
Mailing address:
  • Phone: 405-286-9740
  • Fax: 405-753-5428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number20612
License Number StateOK

VIII. Authorized Official

Name: DR. JAMES BENJAMIN LOWE III
Title or Position: PRESIDENT
Credential: MD
Phone: 405-286-9740