Provider Demographics
NPI:1225206469
Name:ALFRED L. JOWITT D.O., PA
Entity Type:Organization
Organization Name:ALFRED L. JOWITT D.O., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:JOWITT
Authorized Official - Suffix:II
Authorized Official - Credentials:DO
Authorized Official - Phone:903-564-7677
Mailing Address - Street 1:PO BOX 889
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76273-0889
Mailing Address - Country:US
Mailing Address - Phone:903-564-7677
Mailing Address - Fax:903-564-7818
Practice Address - Street 1:109 BOIS D ARC ST
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:TX
Practice Address - Zip Code:76273-1903
Practice Address - Country:US
Practice Address - Phone:903-564-7677
Practice Address - Fax:903-564-7818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0009KHOtherBLUECROSS BLUE SHEILD
TX039012202Medicaid
TX00444VMedicare PIN
G95978Medicare UPIN