Provider Demographics
NPI:1114267382
Name:ROWE S CROWDER III MD PLLC
Entity Type:Organization
Organization Name:ROWE S CROWDER III MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROWE
Authorized Official - Middle Name:SANDERS
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:228-463-1649
Mailing Address - Street 1:202B DRINKWATER RD
Mailing Address - Street 2:
Mailing Address - City:BAY ST LOUIS
Mailing Address - State:MS
Mailing Address - Zip Code:39520-1638
Mailing Address - Country:US
Mailing Address - Phone:228-463-1649
Mailing Address - Fax:228-463-0138
Practice Address - Street 1:202B DRINKWATER RD
Practice Address - Street 2:
Practice Address - City:BAY ST LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520-1638
Practice Address - Country:US
Practice Address - Phone:228-463-1649
Practice Address - Fax:228-463-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
MS14176207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty