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Individual

DR. PRISCILLA GOODWYN FOWLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1720 UNIVERSITY BLVD STE 200, BIRMINGHAM, AL 35233-1816
(205) 876-8988
(205) 390-6460
Mailing address
PO BOX 59449, BIRMINGHAM, AL 35259-9449
(205) 876-8988
(205) 390-6460

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
23473
AL
207W00000X
Ophthalmology Physician
442125
PA
207W00000X
Ophthalmology Physician
ME90933
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
271326800
FL
01
5865700001
MEDICARE DME
FL
Enumeration date
07/01/2005
Last updated
07/22/2024
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