Provider Demographics
NPI:1568673077
Name:LOWRY, WILLIAM J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:LOWRY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:501 DR MICHAEL DEBAKEY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5724
Mailing Address - Country:US
Mailing Address - Phone:337-312-8258
Mailing Address - Fax:337-312-6711
Practice Address - Street 1:1747 IMPERIAL BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5362
Practice Address - Country:US
Practice Address - Phone:337-721-7237
Practice Address - Fax:337-721-7237
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2017-01-30
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Provider Licenses
StateLicense IDTaxonomies
LAMD203940208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1078735Medicaid
LA4P2167460Medicare PIN
LA1078735Medicaid