Individual
CAROLYN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 W 3RD AVE, ALBANY, GA 31701-1985
(229) 312-5800
Mailing address
500 W 3RD AVE, ALBANY, GA 31701-1985
(229) 312-5800
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003056
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206739413A
—
GA
Enumeration date
11/13/2006
Last updated
11/17/2015
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