Provider Demographics
NPI:1205837457
Name:LOWRY, OTIS MEGEL (MD)
Entity Type:Individual
Prefix:DR
First Name:OTIS
Middle Name:MEGEL
Last Name:LOWRY
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:PO BOX 1090
Mailing Address - Street 2:
Mailing Address - City:SPRING HOPE
Mailing Address - State:NC
Mailing Address - Zip Code:27882-1090
Mailing Address - Country:US
Mailing Address - Phone:252-478-5344
Mailing Address - Fax:
Practice Address - Street 1:122 W BRANCH ST
Practice Address - Street 2:
Practice Address - City:SPRING HOPE
Practice Address - State:NC
Practice Address - Zip Code:27882-1090
Practice Address - Country:US
Practice Address - Phone:252-478-5344
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10523207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
53150OtherBCBSNC
NC8953150Medicaid
202281AMedicare ID - Type Unspecified
53150OtherBCBSNC