Provider Demographics
NPI:1225645732
Name:LOY D. COWART III MD PC
Entity Type:Organization
Organization Name:LOY D. COWART III MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOY
Authorized Official - Middle Name:
Authorized Official - Last Name:COWART
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:912-438-5860
Mailing Address - Street 1:154 S LEROY ST
Mailing Address - Street 2:
Mailing Address - City:METTER
Mailing Address - State:GA
Mailing Address - Zip Code:30439-4631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:154 S LEROY ST
Practice Address - Street 2:
Practice Address - City:METTER
Practice Address - State:GA
Practice Address - Zip Code:30439-4631
Practice Address - Country:US
Practice Address - Phone:912-438-5860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty