Healthcare Provider Details

I. General information

NPI: 1003812769
Provider Name (Legal Business Name): DR. JOHN DAVID LOWNEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 12/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 WARWICK AVE
WARWICK RI
02888-3655
US

IV. Provider business mailing address

1050 WARWICK AVE
WARWICK RI
02888-3655
US

V. Phone/Fax

Practice location:
  • Phone: 401-467-6257
  • Fax: 401-785-1191
Mailing address:
  • Phone: 401-467-6257
  • Fax: 401-785-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberDO000317
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: