Dr. Matthew Wayne Fowlkes
Oral & Maxillofacial Surgeon
2003 Forsythe Ave
Monroe
, Louisiana 71201-3608
Dr. Matthew Wayne Fowlkes
Oral & Maxillofacial Surgeon
2003 Forsythe Ave
Monroe
, Louisiana 71201-3608
(318) 388-2835
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About
Features
Specialties
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Matthew Wayne Fowlkes
- 2003 Forsythe Ave
- Monroe, LA
- Zip : 71201-3608
- Fax : (318) 388-2835
- Phone : (318) 388-2621
Second Address
- Dr. Matthew Wayne Fowlkes
- 2003 Forsythe Ave
- Monroe, LA
- Zip : 71201-3608
- Fax : (318) 388-2835
- Phone : (318) 388-2621
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 204E00000X | Oral & Maxillofacial Surgeon | 3464-08 / OS-481-14 | MS |
| Y | 204E00000X | Oral & Maxillofacial Surgeon | 6460 | LA |
National Provider Identifier
| NPI | 1376705087 |
|---|---|
| Provider Name | Dr. Matthew Wayne Fowlkes |
| First Address | Monroe, LA 71201-3608 |
| Second Address | Monroe, LA 71201-3608 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/06/2008 |
| Last Update Date | 14/07/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.