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General NPI Number Information
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NPI Number | 1043339880
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Entity Type | Organization
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Legal Business Name | W.R. FOWLER, M.D.,LLC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3185 N LESLIE RD
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City | SILVER CITY
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State | NM
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Zip | 88061-7211
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Country | US
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Telephone | 505-388-3393
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Fax | 505-388-2696
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Provider Business Mailing Address
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Address Line | 3185 N LESLIE RD
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City | SILVER CITY
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State | NM
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Zip | 88061-7211
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Country | US
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Telephone | 505-388-3393
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Fax | 505-388-2696
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Authorized Official
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Title or Position | CONSULTANT
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Name | MRS. LE ANN ROBINSON
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Credential | R.N.
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Telephone | 505-388-3393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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