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General NPI Number Information
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NPI Number | 1811266943
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Entity Type | Organization
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Legal Business Name | LOUIS B FOWLER JR MD PA
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Dates
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Enumeration Date | 12/19/2011
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Last Update Date | 12/19/2011
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Provider Practice Location Address
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Address Line | 431 E GOVERNMENT ST
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City | PENSACOLA
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State | FL
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Zip | 32502-6131
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Country | US
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Telephone | 850-433-9391
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Fax | 850-433-5881
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Provider Business Mailing Address
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Address Line | 431 E GOVERNMENT ST
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City | PENSACOLA
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State | FL
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Zip | 32502-6131
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Country | US
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Telephone | 850-433-9391
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Fax | 850-433-5881
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Authorized Official
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Title or Position | OWNER
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Name | LOUIS B FOWLER JR.
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Credential | MD
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Telephone | 850-433-9391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME33553
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License Number State | FL
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