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Individual

DR. BRENT CODY MAKIJARVI FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
150 RIVER NORTH BLVD, STEPHENVILLE, TX 76401-1860
(549) 686-0512
Mailing address
4140 CENTENNIAL HILLS BLVD, CASPER, WY 82609-3265
(307) 265-7205

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
14933A
WY
207QS0010X
Sports Medicine (Family Medicine) Physician
14933A
WY
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
T9392
TX

Other

Enumeration date
06/18/2020
Last updated
06/26/2025
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