Provider Demographics
NPI:1558578443
Name:LOWRY, BLANCHE A (MD)
Entity Type:Individual
Prefix:
First Name:BLANCHE
Middle Name:A
Last Name:LOWRY
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 1:2836 N CORTE MELODIA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1298
Mailing Address - Country:US
Mailing Address - Phone:520-326-7769
Mailing Address - Fax:
Practice Address - Street 1:2836 N CORTE MELODIA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1298
Practice Address - Country:US
Practice Address - Phone:520-326-7769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28635207L00000X
NC31866207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0858811OtherBCBS AZ
AZ896904Medicaid
AZ896904Medicaid
AZAZ0858811OtherBCBS AZ