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Individual

DR. JIMMY DEAN FOWLER JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
219 N DUNCAN BYP, UNION, SC 29379-2667
(864) 429-5404
(864) 429-5402
Mailing address
PO BOX 606, UNION, SC 29379-0606
(864) 429-5404
(864) 429-5402

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16124
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
161247
SC
Enumeration date
01/12/2006
Last updated
07/08/2007
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