Provider Demographics
NPI:1164550299
Name:FOWLER & FOWLER, P.C.
Entity Type:Organization
Organization Name:FOWLER & FOWLER, P.C.
Other - Org Name:BLUE SKIES CENTER FOR WOMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-471-3471
Mailing Address - Street 1:140 PARKSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3129
Mailing Address - Country:US
Mailing Address - Phone:719-471-3471
Mailing Address - Fax:719-471-0744
Practice Address - Street 1:140 PARKSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3129
Practice Address - Country:US
Practice Address - Phone:719-471-3471
Practice Address - Fax:719-471-0744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04023586Medicaid
COC198108Medicare PIN
CO198108Medicare PIN