Provider Demographics
NPI:1255352035
Name:LOWERY, JOHN A (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:LOWERY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2325 ABERDEEN BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0624
Mailing Address - Country:US
Mailing Address - Phone:704-853-3937
Mailing Address - Fax:704-853-8029
Practice Address - Street 1:2325 ABERDEEN BLVD
Practice Address - Street 2:STE A
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0624
Practice Address - Country:US
Practice Address - Phone:704-853-3937
Practice Address - Fax:704-853-8029
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2012-12-12
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Provider Licenses
StateLicense IDTaxonomies
IL036104884207W00000X
NC2012-02171207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH40739Medicare UPIN
H40739Medicare UPIN
IL6447860011Medicare NSC
ILIL3270453Medicare PIN