Provider Demographics
NPI:1639352412
Name:CHARLES E LOWREY MD, INC
Entity Type:Organization
Organization Name:CHARLES E LOWREY MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LOWREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-687-0091
Mailing Address - Street 1:2405 N COLUMBUS ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8185
Mailing Address - Country:US
Mailing Address - Phone:740-687-0091
Mailing Address - Fax:740-687-1603
Practice Address - Street 1:2405 N COLUMBUS ST
Practice Address - Street 2:SUITE 220
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8185
Practice Address - Country:US
Practice Address - Phone:740-687-0091
Practice Address - Fax:740-687-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050265207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0918305Medicaid
29854195000OtherBWC
OHF02049Medicare UPIN
OH0918305Medicaid