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Individual

JOSHUA STEPHEN FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
120 MEADOWCREST ST, SUITE 380, GRETNA, LA 70056-5255
(504) 371-3955
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.202191
LA
208D00000X
General Practice Physician
MD.202191
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06488035
MS
05
1002321
LA
Enumeration date
12/28/2007
Last updated
04/28/2015
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