Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 01039645A | IN |
N | 207L00000X | Anesthesiologist | 26869 | WI |
NPI | 1013912997 |
---|---|
Provider Name | Jonathan S. Lowrey |
First Address | Huntingburg, IN 47542-9628 |
Second Address | Huntingburg, IN 47542-9628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 27/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000185797 | BCBS - DEACONESS MARY ST (01) | IN |
000000501005 | BCBS - DEACONESS GATEWAY (01) | IN |
1065073 | FIRST HEALTH# - DEACONESS (01) | |
194556 | HEALTHLINK # - DEACONESS (01) | |
2###0#### | (05) | IL |
200003110 | (05) | IN |
5922739 | AETNA # - DEACONESS (01) | |
64879224 | (05) | KY |
B54683 | (02) | |
P00358546 | RR MEDICARE (01) | IN |