Provider Demographics
NPI:1427027457
Name:COWLEY, BENJAMIN D JR (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:D
Last Name:COWLEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:NEPHROLOGY / AAT5300
Mailing Address - Street 2:OUHSC / 800 STANTON L YOUNG BLVD
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104
Mailing Address - Country:US
Mailing Address - Phone:405-271-6842
Mailing Address - Fax:405-271-6496
Practice Address - Street 1:1000 NE 13TH ST STE 1G
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5040
Practice Address - Country:US
Practice Address - Phone:405-271-8478
Practice Address - Fax:405-271-4230
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22666207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
24R601878Medicare PIN