Provider Demographics
NPI:1316916562
Name:LOWERY, CHRIS A (DO)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:A
Last Name:LOWERY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7203
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-7303
Mailing Address - Country:US
Mailing Address - Phone:317-682-2038
Mailing Address - Fax:317-773-3322
Practice Address - Street 1:9660 E 146TH ST STE 100
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-3097
Practice Address - Country:US
Practice Address - Phone:317-773-6677
Practice Address - Fax:317-773-3322
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002963A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200540630Medicaid
INI40898Medicare UPIN
IN200540630Medicaid