Provider Demographics
NPI:1659749133
Name:DONALDSON FOWLER LLC
Entity Type:Organization
Organization Name:DONALDSON FOWLER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:859-802-8946
Mailing Address - Street 1:31 ELLEN KAY DR
Mailing Address - Street 2:
Mailing Address - City:DRY RIDGE
Mailing Address - State:KY
Mailing Address - Zip Code:41035-9758
Mailing Address - Country:US
Mailing Address - Phone:859-824-7965
Mailing Address - Fax:859-824-7965
Practice Address - Street 1:141 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:KY
Practice Address - Zip Code:41097-1751
Practice Address - Country:US
Practice Address - Phone:859-802-8946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1037238261QR0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care