| John W Fowler Jr. Md Pllc | |
|
184 Colonial Rd Memphis TN 38117-3206 | |
| (901) 844-2500 | |
| Not Available |
| Full Name | John W Fowler Jr. Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 184 Colonial Rd, Memphis, Tennessee |
| Authorized Official Name and Position | John W Fowler (SOLE MEMBER) |
| Authorized Official Contact | 9018442500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John W Fowler Jr. Md Pllc Po Box 770175 Memphis TN 38177-0175 Ph: (901) 844-2500 | John W Fowler Jr. Md Pllc 184 Colonial Rd Memphis TN 38117-3206 Ph: (901) 844-2500 |
| NPI Number | 1396182705 |
|---|---|
| Provider Enumeration Date | 05/24/2013 |
| Last Update Date | 05/24/2013 |
| Medicare PECOS PAC ID | 7113166117 |
|---|---|
| Medicare Enrollment ID | O20130624000711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396182705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD011043 (Tennessee) | Primary |
| Provider Name | John W Fowler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982658506 PECOS PAC ID: 2365542420 Enrollment ID: I20070703000384 |
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