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Individual

DR. GRACE ELAINE FOWLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
626 PRAIRE STREET, VINCENNES, IN 47591-1060
(812) 882-5524
(812) 882-5525
Mailing address
PO BOX 30, VINCENNES, IN 47591-0030
(812) 882-5524
(812) 882-5525

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02003008A
IN
208000000X
Pediatrics Physician
02003008A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200391740A
IN
Enumeration date
08/25/2006
Last updated
03/19/2009
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