Provider Demographics
NPI:1093431124
Name:FOWLER, STEPHEN SCOTT JR (PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:SCOTT
Last Name:FOWLER
Suffix:JR
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:4104 TRACY CT
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-3013
Mailing Address - Country:US
Mailing Address - Phone:856-449-0644
Mailing Address - Fax:
Practice Address - Street 1:435 HURFFVILLE CROSS KEYS RD
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2453
Practice Address - Country:US
Practice Address - Phone:856-582-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant