Provider Demographics
NPI:1275852055
Name:LOWE, TYLER JAMES (OD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:JAMES
Last Name:LOWE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 ROUTE 1 BYPASS
Mailing Address - Street 2:SUITE A
Mailing Address - City:KITTERY
Mailing Address - State:ME
Mailing Address - Zip Code:03904
Mailing Address - Country:US
Mailing Address - Phone:207-439-0410
Mailing Address - Fax:207-439-8353
Practice Address - Street 1:99 ROUTE 1 BYPASS
Practice Address - Street 2:SUITE A
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904
Practice Address - Country:US
Practice Address - Phone:207-439-0410
Practice Address - Fax:207-439-8353
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME916152W00000X
NH843152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist