Provider Demographics
NPI:1780698274
Name:LOWRY, JONATHAN CARDEEN (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:CARDEEN
Last Name:LOWRY
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 1:335 E PARKER RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-5112
Mailing Address - Country:US
Mailing Address - Phone:828-433-1000
Mailing Address - Fax:828-433-6274
Practice Address - Street 1:335 E PARKER RD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5112
Practice Address - Country:US
Practice Address - Phone:828-433-1000
Practice Address - Fax:828-433-6274
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500648207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC53145OtherBLUE CROSS BLUE SHIELD NC
NC8916651Medicaid
NC8916651Medicaid
NC2215042Medicare PIN
NC2215042CMedicare PIN
NC2215042BMedicare PIN
E56497Medicare UPIN
NC2215042AMedicare PIN