Organization
ALDER MEDICAL CENTER PC
Active
Other names
Alder Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY HOUGH LOWTHER MD (PRESIDENT)
(541) 469-5919
Entity
Organization
Contact information
Practice address
412 ALDER ST, BROOKINGS, OR 97415-9014
(541) 469-5919
(541) 469-6710
Mailing address
PO BOX 5750, BROOKINGS, OR 97415-0125
(541) 469-5919
(541) 469-6710
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD22599
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288201
—
OR
Enumeration date
10/13/2005
Last updated
08/22/2020
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