Provider Demographics
NPI:1346220449
Name:FOWLER, MARK J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:FOWLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 11450
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4005
Mailing Address - Country:US
Mailing Address - Phone:479-709-1924
Mailing Address - Fax:479-709-7499
Practice Address - Street 1:1500 DODSON AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-5182
Practice Address - Country:US
Practice Address - Phone:479-709-7490
Practice Address - Fax:479-709-7495
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2016-11-23
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Provider Licenses
StateLicense IDTaxonomies
SC19869207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology