Individual
SUSAN S LOWRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
117 KENNEDY DR, MARTIN, TN 38237-3394
(731) 587-9511
(877) 309-6416
Mailing address
117 KENNEDY DR, MARTIN, TN 38237-3309
(731) 587-9511
(877) 309-6416
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD26758
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2646506
AMERIGROUP
—
01
—
3028491
BLUE CROSS BLUE SHIELD
TN
05
—
3091111
—
TN
01
—
5281135
AETNA
—
Enumeration date
07/18/2005
Last updated
05/26/2021
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