Individual
EVAN FOWLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
225 NE 97TH ST STE 600, OKLAHOMA CITY, OK 73114-6302
(405) 842-2061
Mailing address
14275 MIDWAY RD STE 400, ADDISON, TX 75001-3614
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
6290
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2012
Last updated
08/11/2022
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