Provider Demographics
NPI:1689712622
Name:LOWENSTEIN, MATTHEW SCOTT (OD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:SCOTT
Last Name:LOWENSTEIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12120 S STRANG LINE RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5219
Mailing Address - Country:US
Mailing Address - Phone:913-244-1262
Mailing Address - Fax:913-397-7303
Practice Address - Street 1:12120 S STRANG LINE RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5219
Practice Address - Country:US
Practice Address - Phone:913-244-1262
Practice Address - Fax:877-730-1275
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1535152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100410380AMedicaid
KS100410380BMedicaid
KS100410380BMedicaid
KSU70434Medicare UPIN
KS650831Medicare ID - Type UnspecifiedDOUGLASS COUNTY #