Provider Demographics
NPI:1689641367
Name:JOWERS, JOSEPH RAYBURN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RAYBURN
Last Name:JOWERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:R
Other - Last Name:JOWERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:503 CLARK ST NE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-1921
Mailing Address - Country:US
Mailing Address - Phone:256-739-0801
Mailing Address - Fax:256-739-0027
Practice Address - Street 1:1800 AL HIGHWAY 157 STE 101
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-1273
Practice Address - Country:US
Practice Address - Phone:256-739-4131
Practice Address - Fax:256-962-5445
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP00175207OtherRAILROAD MEDICARE
AL117967Medicaid
AL1164743068Medicaid
H13446Medicare UPIN