Provider Demographics
NPI:1114986890
Name:STOWELL, ERIK D (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:D
Last Name:STOWELL
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 1:242 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2477
Mailing Address - Country:US
Mailing Address - Phone:541-683-4242
Mailing Address - Fax:541-343-5078
Practice Address - Street 1:242 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-683-4242
Practice Address - Fax:541-343-5078
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD22326174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR050406Medicaid
118504Medicare ID - Type Unspecified
E95389Medicare UPIN