Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 23528 | MS |
Y | 207P00000X | Emergency Physician | MD.206893 | LA |
NPI | 1013202019 |
---|---|
Provider Name | Bruce B Lowry |
First Address | New Orleans, LA 70121-2429 |
Second Address | New Orleans, LA 70115-6914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2011 |
Last Update Date | 07/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04231569 | (05) | MS |
2370600 | (05) | LA |