Individual
DR. AMANDA HORNE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPT. OF MEDICINE, JACKSON, MS 39216-4500
(601) 984-5601
(601) 984-6665
Mailing address
2500 N STATE ST, DEPT. OF MEDICINE, JACKSON, MS 39216-4500
(601) 984-5601
(601) 984-6665
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
22571
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00886302
—
MS
Enumeration date
07/05/2011
Last updated
11/17/2016
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