Individual
JOHN WAKON FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
203 WATSON ST STE 200, PRATT, KS 67124-3092
(620) 672-7422
(620) 508-6476
Mailing address
20351 SE 20TH AVE, PRATT, KS 67124-8145
(620) 672-7422
(620) 508-6476
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0427026
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100297620D
—
KS
Enumeration date
06/13/2005
Last updated
08/25/2014
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