Provider Demographics
NPI:1285682195
Name:LOWRY, HAROLD D (MD)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:D
Last Name:LOWRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1010 1ST ST SE STE 230
Mailing Address - Street 2:
Mailing Address - City:BANDON
Mailing Address - State:OR
Mailing Address - Zip Code:97411-9309
Mailing Address - Country:US
Mailing Address - Phone:541-347-2529
Mailing Address - Fax:541-347-9196
Practice Address - Street 1:1312 TICHENOR ST
Practice Address - Street 2:
Practice Address - City:PORT ORFORD
Practice Address - State:OR
Practice Address - Zip Code:97465-8776
Practice Address - Country:US
Practice Address - Phone:541-347-2529
Practice Address - Fax:541-347-9196
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14168207Q00000X
ORMD192768208000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500772421Medicaid