Provider Demographics
NPI:1306826441
Name:LOWER, THOMAS J (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:LOWER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-5305
Mailing Address - Country:US
Mailing Address - Phone:515-237-3974
Mailing Address - Fax:515-288-0122
Practice Address - Street 1:127 W WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1248
Practice Address - Country:US
Practice Address - Phone:641-342-6568
Practice Address - Fax:641-342-4656
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01602207Q00000X
IADO-01602207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA080004877OtherPALMETTO GBA BILLING ID
IA16458OtherBLUE CROSS BLUE SHEILD
IA164580001OtherMEDICARE PIN-INDIVIDUAL
IA080004877OtherPALMETTO GBA INDV ID
IA16458OtherMEDICARE PIN-GROUP
IA0164582Medicaid
IA0164582Medicaid