Provider Demographics
NPI:1528009370
Name:LOWENGART, RUTH ANN (MD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:LOWENGART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 SISKIYOU BLVD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8125
Mailing Address - Country:US
Mailing Address - Phone:541-776-5111
Mailing Address - Fax:
Practice Address - Street 1:2627 SISKIYOU BLVD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8125
Practice Address - Country:US
Practice Address - Phone:541-776-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18869204D00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR068655Medicaid
ORF92974Medicare UPIN
OR0000BKZBFMedicare ID - Type Unspecified