Provider Demographics
NPI:1821276437
Name:LISA LOWERY MD INC
Entity Type:Organization
Organization Name:LISA LOWERY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-729-6900
Mailing Address - Street 1:10400 BLACKLICK EASTERN RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8235
Mailing Address - Country:US
Mailing Address - Phone:614-729-6900
Mailing Address - Fax:614-224-8557
Practice Address - Street 1:10400 BLACKLICK EASTERN RD
Practice Address - Street 2:SUITE 110
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-8235
Practice Address - Country:US
Practice Address - Phone:614-729-6900
Practice Address - Fax:614-224-8557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35066309332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE98334Medicare UPIN
OH5663790001Medicare NSC