Provider Demographics
NPI:1558562058
Name:LOWTHERT, LORI ANNE (MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANNE
Last Name:LOWTHERT
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 1:7256 ASHBERRY CT
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-9066
Mailing Address - Country:US
Mailing Address - Phone:203-240-7755
Mailing Address - Fax:
Practice Address - Street 1:2191 E JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6029
Practice Address - Country:US
Practice Address - Phone:850-494-3953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.357472084P0800X
WI100301-8752084P0800X
MI43015087322084P0800X
FL1229182084P0800X
WI82021-202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry