Healthcare Provider Details

I. General information

NPI: 1447449020
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL LOWTHER, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 GERRANS AVE
CODY WY
82414-4120
US

IV. Provider business mailing address

802 GERRANS AVE
CODY WY
82414-4120
US

V. Phone/Fax

Practice location:
  • Phone: 307-587-7000
  • Fax: 307-587-7009
Mailing address:
  • Phone: 307-587-7000
  • Fax: 307-587-7009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number5252A
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5252A
License Number StateWY

VIII. Authorized Official

Name: CHRISTOPHER MICHAEL LOWTHER
Title or Position: OWNER
Credential: M.D.
Phone: 307-587-7000