Provider Demographics
NPI:1184622250
Name:ANTHONY, LOWELL BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:BRIAN
Last Name:ANTHONY
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 1:800 ROSE ST
Mailing Address - Street 2:CC401
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0093
Mailing Address - Country:US
Mailing Address - Phone:859-323-6522
Mailing Address - Fax:859-257-7715
Practice Address - Street 1:MARKEY CANCER CTR
Practice Address - Street 2:800 ROSE STREET, WHITNEY HEDRICKSON BLDG
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-6522
Practice Address - Fax:859-257-7715
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11661R207RH0003X
KYTP143207RH0003X
KY44782207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01653581Medicaid
AR135416001Medicaid
LA1378453Medicaid
KY44782OtherKENTUCKY MEDICAL LICENSE
KY6491661200Medicaid
LA5Y008Medicare PIN
LA1378453Medicaid
LAA98081Medicare UPIN
KYK022140Medicare PIN
LA5Y008F668Medicare PIN
KY6491661200Medicaid