Individual
ZACHARY ALAN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1717 S UTICA AVE STE A, TULSA, OK 74104-5346
(918) 748-7557
(918) 748-7514
Mailing address
1717 S UTICA AVE STE A, TULSA, OK 74104-5346
(918) 748-7557
(918) 748-7514
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4900
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200294460B
—
OK
Enumeration date
06/18/2009
Last updated
06/05/2014
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