Individual
MR. JASON LEE FOWLER
Active
Individual
MR. JASON LEE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004150
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001332483
ANTHEM PROVIDER ID NUMBER
—
01
—
2143551
WELLCARE OF KY PROVIDER ID NUMBER
KY
05
—
300033296
—
IN
01
—
6464207
CIGNA PROVIDER ID NUMBER
—
01
—
6830783
UNITED HEALTHCARE PROVIDER ID NUMBER
—
05
—
7100642510
—
KY
01
—
CS2003600562
CARESOURCE PROVIDER ID NUMBER
—
01
—
PDZ000000455121
AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
KY
Enumeration date
04/23/2008
Last updated
07/12/2022
Update your record
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