Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 37578 | KY |
NPI | 1104854207 |
---|---|
Provider Name | Dr. Charles E Lowe III |
First Address | Pikeville, KY 41501 |
Second Address | Pikeville, KY 41501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 20/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11175801 | CAQH (01) | |
64063340 | (05) | KY |
H80535 | (02) |