Provider Demographics
NPI:1750490512
Name:LOWE, ERNEST B JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:B
Last Name:LOWE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 S LAMAR BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655
Mailing Address - Country:US
Mailing Address - Phone:662-234-4446
Mailing Address - Fax:662-234-2961
Practice Address - Street 1:2200 S LAMAR BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655
Practice Address - Country:US
Practice Address - Phone:662-234-4446
Practice Address - Fax:662-234-2961
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS12255207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Not Answered207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00011021Medicaid
MS00011021Medicaid