Provider Demographics
NPI:1649501214
Name:FOWLER, SHERRY ANN (PHD, DO)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:ANN
Last Name:FOWLER
Suffix:
Gender:F
Credentials:PHD, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27645 SOUTH MAPLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WASHBURN
Mailing Address - State:WI
Mailing Address - Zip Code:54891
Mailing Address - Country:US
Mailing Address - Phone:715-373-5202
Mailing Address - Fax:
Practice Address - Street 1:27645 SOUTH MAPLE HILL RD
Practice Address - Street 2:
Practice Address - City:WASHBURN
Practice Address - State:WI
Practice Address - Zip Code:54891
Practice Address - Country:US
Practice Address - Phone:715-373-5202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33497-021207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology