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Individual

DR. RANDY GENE COWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1350 CEDAR CT, CARBONDALE, IL 62901-5336
(618) 529-2955
(618) 457-7823
Mailing address
1350 CEDAR CT, CARBONDALE, IL 62901-5336
(618) 529-2955
(618) 457-7823

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036-085906
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36-085906
IL
Enumeration date
07/13/2005
Last updated
02/17/2009
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