# DR. JUSTIN FOWLER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1386835585
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171000000X | Military Health Care Provider | — | NULL | — |
| 207XX0801X | Orthopaedic Trauma Physician | 2016027259 | MO | — |
| 207XX0801X | Orthopaedic Trauma Physician | M-13069 | ID | — |
| 207XX0801X | Orthopaedic Trauma Physician | MD2014-0304 | NM | — |
| 207XX0801X | Orthopaedic Trauma Physician | Q6009 | TX | — |
| 2086S0102X | Surgical Critical Care Physician | M-13069 | ID | Yes |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 12/16/2024