Provider Demographics
NPI:1528040268
Name:ROWLEY, NICHOLAS J (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:J
Last Name:ROWLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 COMMERCE WAY
Mailing Address - Street 2:STE 104
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-4775
Mailing Address - Country:US
Mailing Address - Phone:575-762-3385
Mailing Address - Fax:575-762-3386
Practice Address - Street 1:201 COMMERCE WAY
Practice Address - Street 2:STE 104
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-4775
Practice Address - Country:US
Practice Address - Phone:575-762-3385
Practice Address - Fax:575-762-3386
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM76258207Y00000X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM850253170OtherHEALTHSMART
NM25095OtherPRESBYTERIAN HEALTHCARE
NM850253170OtherMOLINA HEALTHCARE
NMOONM002357OtherBCBS
NM23663Medicaid
NM850253170OtherWISCONSIN PHYSICIAN SVCS
TX073050901Medicaid
NM201008586OtherPRESBYTERIAN SALUD
NM850253170OtherCARE
NM850253170OtherUNITED HEALTHCARE
NM850253170OtherLOVELACE HEALTHCARE
NM347733301Medicare PIN
C98071Medicare UPIN