Provider Demographics
NPI:1689607343
Name:JOYCE FOWLER, P.A.
Entity Type:Organization
Organization Name:JOYCE FOWLER, P.A.
Other - Org Name:THE FOWLER INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:501-664-6632
Mailing Address - Street 1:415 N MCKINLEY ST STE 500
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3018
Mailing Address - Country:US
Mailing Address - Phone:501-664-6632
Mailing Address - Fax:501-664-1441
Practice Address - Street 1:415 N MCKINLEY ST STE 500
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3018
Practice Address - Country:US
Practice Address - Phone:501-664-6632
Practice Address - Fax:501-664-1441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR03-13P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR56230OtherBLUECROSS BLUESHIELD
AR5Y284OtherBLUECROSS BLUESHIELD
ARQ09887Medicare UPIN
AR5Y284Medicare UPIN
AR5Y284-C979Medicare ID - Type Unspecified
AR56230-C979Medicare ID - Type Unspecified