Provider Demographics
NPI:1023035664
Name:LOWRANCE, WILLIAM L (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:LOWRANCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1793
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29641-1793
Mailing Address - Country:US
Mailing Address - Phone:864-855-6811
Mailing Address - Fax:864-855-6784
Practice Address - Street 1:403 HILLCREST DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640
Practice Address - Country:US
Practice Address - Phone:864-855-6811
Practice Address - Fax:864-855-6784
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7514208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP0270Medicaid
340002696OtherRAILROAD MEDICARE
340002696OtherRAILROAD MEDICARE
SCGP0270Medicaid