Provider Demographics
NPI:1659697779
Name:LOWE, PAUL F (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:F
Last Name:LOWE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 SW 59TH ST
Mailing Address - Street 2:(INSIDE IL MARIACHI)
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-8303
Mailing Address - Country:US
Mailing Address - Phone:405-631-0611
Mailing Address - Fax:
Practice Address - Street 1:415 SW 59TH ST
Practice Address - Street 2:(INSIDE IL MARIACHI)
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-8303
Practice Address - Country:US
Practice Address - Phone:405-631-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPA1886363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant