Provider Demographics
NPI:1376590174
Name:LOWERY, TRACY ALAN (MD)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:ALAN
Last Name:LOWERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 WHITESPORT DR SW
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6486
Mailing Address - Country:US
Mailing Address - Phone:256-429-5346
Mailing Address - Fax:
Practice Address - Street 1:185 WHITESPORT DR SW
Practice Address - Street 2:SUITE 2
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6486
Practice Address - Country:US
Practice Address - Phone:256-429-5346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000167832086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery