Provider Demographics
NPI:1265496392
Name:LOWERY, JOLENE B (MD)
Entity Type:Individual
Prefix:
First Name:JOLENE
Middle Name:B
Last Name:LOWERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOLENE
Other - Middle Name:A
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:800 WALNUT STREET
Mailing Address - Street 2:14TH FL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:215-829-3445
Mailing Address - Fax:215-829-3486
Practice Address - Street 1:800 WALNUT STREET
Practice Address - Street 2:14TH FL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:215-829-3445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD58959207R00000X
GA64857207RE0101X
PAMD430400207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA64857OtherSTATE LICENSE
MDD58959OtherSTATE LICENSE
GA64857OtherSTATE LICENSE
PAMT189589OtherSTATE TRAINING