Basic Information
| Provider Information | |||||||||
| NPI: | 1194895854 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LOWRY NEUROSURGICAL CLINIC, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1797 | ||||||||
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| City: | LAUREL | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394411797 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6014257522 | ||||||||
| FaxNumber: | 6014287841 | ||||||||
| Practice Location | |||||||||
| Address1: | 1007 JEFFERSON ST | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394404350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6014257522 | ||||||||
| FaxNumber: | 6014287841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | LOWRY | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6014257522 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 7684 | MS | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.