Individual
DOUGLAS R FOWNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
723 PARK RIDGE LN, NORTH FOND DU LAC, WI 54937-1385
(920) 926-8600
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21386
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080076569
RAILROAD MEDICARE
WI
05
—
30204900
—
WI
Enumeration date
11/02/2005
Last updated
03/03/2016
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