Individual
DR. JERRY LANE LOWDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4901 FOREST PARK AVE, DIV OBGYN PELVIC MED/RECONSTRUCT SURG, STE 710, SAINT LOUIS, MO 63108-1495
(314) 747-1402
(314) 362-3328
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 747-1402
(314) 362-3328
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2013044288
MO
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
2013044288
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200011086
—
MO
Enumeration date
02/15/2006
Last updated
04/17/2025
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