Healthcare Provider Details

I. General information

NPI: 1518042332
Provider Name (Legal Business Name): ALFRED LEONARD JOWITT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 BOIS D ARC
WHITESBORO TX
76273
US

IV. Provider business mailing address

PO BOX 889
WHITESBORO TX
76273
US

V. Phone/Fax

Practice location:
  • Phone: 903-564-7677
  • Fax: 903-564-7818
Mailing address:
  • Phone: 903-564-7677
  • Fax: 903-564-7818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK6476
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: