Provider Demographics
NPI:1669462644
Name:LOWE, VICKIE CAROL (MD)
Entity Type:Individual
Prefix:DR
First Name:VICKIE
Middle Name:CAROL
Last Name:LOWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VICKIE
Other - Middle Name:C
Other - Last Name:WHOBREY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 E LIBERTY ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1434
Mailing Address - Country:US
Mailing Address - Phone:502-587-4391
Mailing Address - Fax:502-479-1425
Practice Address - Street 1:200 ABRAHAM FLEXNER WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1886
Practice Address - Country:US
Practice Address - Phone:502-587-4391
Practice Address - Fax:502-479-1425
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY27635208100000X, 225400000X, 2081H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201163810A (JPG)Medicaid
KY000000050299OtherANTHEM
KY64276355Medicaid
163857500OtherDEPARTMENT OF LABOR
KY250006816OtherRAILROAD RETIREMENT
KY2432324000OtherPASSPORT ADVANTAGE
KY50030753OtherPASSPORT
KY50030753OtherPASSPORT
KY000000050299OtherANTHEM
KYK093600 JPGMedicare PIN
KY64276355Medicaid
KY250006816OtherRAILROAD RETIREMENT