Provider Demographics
NPI:1760687123
Name:LOWMAN, TOM (MD)
Entity Type:Individual
Prefix:DR
First Name:TOM
Middle Name:
Last Name:LOWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-2943
Mailing Address - Country:US
Mailing Address - Phone:304-788-5117
Mailing Address - Fax:304-788-5117
Practice Address - Street 1:536 S MAIN ST
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-2943
Practice Address - Country:US
Practice Address - Phone:304-788-5117
Practice Address - Fax:304-788-5117
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0470192Medicare ID - Type Unspecified