MEDICARE: DR. RICHARD GREGORY LOWE PH.D., AU.D.

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	231H00000X	Audiologist	23001004	IN

General Provider Information

NPI Number	:	1700850518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD GREGORY LOWE PH.D., AU.D.

Provider Business Mailing Address
First Line	:	3124 E STATE BLVD
Second Line	:	SUITE 1A
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-4763
Country	:	US
Telephone Number	:	260-471-5693
Fax Number	:	260-471-4942

Provider Business Practice Location Address
First Line	:	3124 E STATE BLVD
Second Line	:	SUITE 1A
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-4763
Country	:	US
Telephone Number	:	260-471-5693
Fax Number	:	260-471-4942

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

Provider Enumeration Date	:	02/16/2006
Last Update Date	:	07/08/2007

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