Individual
MR. JACK H. FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6801 AIRPORT BLVD, MOBILE, AL 36608-3709
(251) 631-3270
(251) 631-3273
Mailing address
612 SHENANDOAH RD W, MOBILE, AL 36608-3353
(251) 344-3180
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-062685
AL
Other
Enumeration date
04/18/2006
Last updated
01/12/2009
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