Provider Demographics
NPI:1407980956
Name:LOWHAM SURGERY AND ENDOSCOPY, PC
Entity Type:Organization
Organization Name:LOWHAM SURGERY AND ENDOSCOPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:S
Authorized Official - Last Name:LOWHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-335-8141
Mailing Address - Street 1:1330 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-9701
Mailing Address - Country:US
Mailing Address - Phone:307-335-8141
Mailing Address - Fax:
Practice Address - Street 1:195 CAPITOL ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-3928
Practice Address - Country:US
Practice Address - Phone:307-335-8141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY6284A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY308021Medicare ID - Type Unspecified
WYG93013Medicare UPIN