Individual
PHILLIP LOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 E BROADWAY, SUITE 207, JACKSON, WY 83001
(307) 733-7460
(307) 733-7482
Mailing address
PO BOX 12890, JACKSON, WY 83002-2890
(307) 733-7460
(307) 733-7482
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
6215A
WY
2088P0231X
Pediatric Urology Physician
6215A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114954700
—
WY
05
—
118827500
—
WY
05
—
806233600
—
ID
05
—
806684400
—
ID
Enumeration date
12/27/2006
Last updated
06/18/2008
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