MEDICARE: DR. JAMES RUSSELL LOWREY DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	PO2798	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	65615	OTHER		BLUE CROSS BLUE SHIELD
3	030514682	OTHER		TAX ID
4	219678	OTHER	FL	AMERIGROUP
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124080866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES RUSSELL LOWREY DPM

Provider Business Mailing Address
First Line	:	8583 W LINEBAUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-3731
Country	:	US
Telephone Number	:	813-855-3606
Fax Number	:	813-926-0632

Provider Business Practice Location Address
First Line	:	8583 W LINEBAUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-3731
Country	:	US
Telephone Number	:	813-855-3606
Fax Number	:	813-926-0632

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	10/21/2011

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