Provider Demographics
NPI:1770573578
Name:LOWRY, TULULA LOCKLEAR (MD)
Entity type:Individual
Prefix:
First Name:TULULA
Middle Name:LOCKLEAR
Last Name:LOWRY
Suffix:
Gender:F
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:ROBESON COUNTY CBOC
Mailing Address - Street 2:139 THREE HUNTS DRIVE
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372
Mailing Address - Country:US
Mailing Address - Phone:910-272-3220
Mailing Address - Fax:910-521-8620
Practice Address - Street 1:ROBESON COUNTY CBOC
Practice Address - Street 2:139 THREE HUNTS DRIVE
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372
Practice Address - Country:US
Practice Address - Phone:910-272-3220
Practice Address - Fax:910-521-8620
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7953148Medicaid
NC7953148Medicaid
2232157Medicare UPIN