Basic Information
| Provider Information | |||||||||
| NPI: | 1336308949 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THOMAS J LOWER DO PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2213 GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503125305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152373974 | ||||||||
| FaxNumber: | 5152880122 | ||||||||
| Practice Location | |||||||||
| Address1: | 127 W WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | OSCEOLA | ||||||||
| State: | IA | ||||||||
| PostalCode: | 502131248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6413426568 | ||||||||
| FaxNumber: | 6413424656 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2008 | ||||||||
| LastUpdateDate: | 02/27/2015 | ||||||||
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| AuthorizedOfficialLastName: | LOWER | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6413426568 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 01602 | IA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 16458 | 01 | BLUE CROSS BLUE SHIELD | OTHER | 0164582 | 05 | IA | MEDICAID | 080004877 | 01 | PALMETTO GBA | OTHER |