Individual
JUSTIN DAVID FOWLKES
Active
Individual
JUSTIN DAVID FOWLKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD.204656
LA
207RP1001X
Pulmonary Disease Physician
Primary
MD.204656
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2106520
—
LA
Enumeration date
03/19/2010
Last updated
09/15/2017
Update your record
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