Provider Demographics
NPI:1619908126
Name:LOWELL, JEFFREY A (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:LOWELL
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 1:2131 K ST NW
Mailing Address - Street 2:#700
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1898
Mailing Address - Country:US
Mailing Address - Phone:202-715-4225
Mailing Address - Fax:202-775-1599
Practice Address - Street 1:2131 K ST NW
Practice Address - Street 2:#700
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1898
Practice Address - Country:US
Practice Address - Phone:202-715-4225
Practice Address - Fax:202-775-1599
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105476204F00000X, 2086S0102X, 2086S0120X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO075010181Medicaid
MO075010181Medicaid
MO075010181Medicaid
MO075010181Medicare PIN