Basic Information
| Provider Information | |||||||||
| NPI: | 1831623891 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOWREY | ||||||||
| FirstName: | CASEY | ||||||||
| MiddleName: | MOORE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4037 NW 86TH TER | ||||||||
| Address2: | ROOM 3154 | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326069277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522944945 | ||||||||
| FaxNumber: | 3525941818 | ||||||||
| Practice Location | |||||||||
| Address1: | 107 2ND AVE SE | ||||||||
| Address2: | |||||||||
| City: | CULLMAN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350553511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567394910 | ||||||||
| FaxNumber: | 2567399455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2017 | ||||||||
| LastUpdateDate: | 07/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | MD43987 | AL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.