Provider Demographics
NPI:1104854207
Name:LOWE, CHARLES E III (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:E
Last Name:LOWE
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:5425 NORTH MAYO TRAIL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501
Mailing Address - Country:US
Mailing Address - Phone:606-433-0591
Mailing Address - Fax:606-433-0594
Practice Address - Street 1:5425 NORTH MAYO TRAIL
Practice Address - Street 2:SUITE 101
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501
Practice Address - Country:US
Practice Address - Phone:606-433-0591
Practice Address - Fax:606-433-0594
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2013-12-20
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Provider Licenses
StateLicense IDTaxonomies
KY37578207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64063340Medicaid
11175801OtherCAQH
11175801OtherCAQH