Provider Demographics
NPI:1649244179
Name:TOWERY, MARION WALTER (MD)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:WALTER
Last Name:TOWERY
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 1:1151 N. STATE ST.
Mailing Address - Street 2:SUITE 311
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202
Mailing Address - Country:US
Mailing Address - Phone:601-969-1171
Mailing Address - Fax:601-969-1173
Practice Address - Street 1:1151 N. STATE ST.
Practice Address - Street 2:SUITE 311
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202
Practice Address - Country:US
Practice Address - Phone:601-969-1171
Practice Address - Fax:601-969-1173
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00025517207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009937371Medicaid
AL51534608OtherBCBS O F AL
GA845552295AMedicaid
AL009936861Medicaid
AL51534610OtherBCBS OF AL
AL009936859Medicaid
AL51534609OtherBCBS OF AL
GA845552295AMedicaid
AL009937371Medicaid